Penetration in trochanteric fractures of the femur treated with rigid nail plates.
One hundred and twelve trochanteric fractures have been analysed. A Jewett nail-plate was used in 81 patients and a Thorton nail-McLaughlin plate in 31. Penetration of the nail into or through the hip joint was the only complication studied in detail. It occurred in 41 cases: 31 (38 per cent) with the Jewett nails and 10 (33 per cent) in the other group. Both groups are comparable in that the nail-plate acts as a single rigid unit and the nail/plate angle varied, but the overall incidence of migration of the nail was similar. All the 112 cases were reviewed as one group. Penetration was more common in comminuted unstable types of fracture, in those poorly fixed, and in the older patients. Sixteen (14 per cent) well-fixed fractures showed penetration. It appears that one important additional reason for penetration in this series was the rigidity of the device and the poor quality of the bone. The incidence of nail penetration in comminuted unstable fractures of the femur might be reduced by using methods of fixation other than rigid nail-plates.
D000368:Aged; D001858:Bone Nails / Q000009:adverse effects*; D001860:Bone Plates / Q000009:adverse effects*; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation; D050723:Fractures, Bone / Q000601:surgery*; D005596:Fractures, Closed / Q000601:surgery*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged