title: The classic nail in the therapy of trochanteric fractures.A prospective, controlled study.
abstract: In a prospective controlled study we analysed the classic nail, a new intramedullary implant for the fixation of peritrochanteric fractures. By means of lateral bending of 4 degrees, unreamed implantation is generally possible. Our collective of 85 patients was characterized by elderly mean age (82.3 years), a predominance of female patients (4.3 : 1), a minor trauma aetiology without relevant additional injuries, and a high rate of concomitant disease (92%). Only 31A-type femur fractures were treated, with a low specific complication rate of 13%, whereby operative revision was necessary in only two patients (3%). A good anatomic reconstruction and full weight-bearing with the osteosynthesis was achieved in the majority of patients. No secondary shaft fractures and only one case of cutting out was observed. The mortality (30 days: 18%, 6 months: 25%) as well as the high rate of unspecific complications (20%) were caused by the patients' multiple morbidity. Deficits in the Merle d'Aubigne score at follow-up after 6 months can be interpreted within the same context. Nevertheless, 85% could return to their former social environment and only 15% became dependent on a nursing institution in connection with the fracture treatment.
authors.affiliation: University Hospital Heidelberg, Department of Traumatology, INF 110, D-69120 Heidelberg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Fritz
authors.forename: C
authors.initials: C
authors.lastname: Weiss
authors.forename: C
authors.initials: C
authors.lastname: Krieglstein
authors.forename: A
authors.initials: A
authors.lastname: Quentmeier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails / Q000191:economics; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D015996:Survival Rate; D016896:Treatment Outcome