Application of Kuntscher Y nailing for fractures involving upper end of femur.
Kuntscher Y nail is biomechanically a stable assembly and is useful in the management of unstable intertrochanteric, subtrochanteric and pathological fractures involving the upper end of the femur. In addition, it was ideal in special situations with fracture of the upper end of the femur; in a mentally ill patient with an unstable trochanteric fracture, for non-union of a trochanteric fracture and for a fracture of the upper end of the femur associated with a fracture further distally of the femoral shaft. Although it proved to be a very stable fixation, the control of external rotation of the distal femoral shaft was a significant problem in two cases. In all six cases stable fixation was achieved which progressed to sound union, including the case with ununited fracture. No technical difficulty was encountered at the time of operation although this could pose a significant problem. The main danger is the splintering of the lateral subtrochanteric femoral cortex during insertion of the neck piece and inability to negotiate the Kuntscher nail through the fenestration in the neck piece.
D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D001858:Bone Nails; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005598:Fractures, Spontaneous / Q000601:surgery; D005599:Fractures, Ununited / Q000601:surgery; D006620:Hip Fractures / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged