title: The Holland nail: a universal implant for fractures of the proximal femur and the femoral shaft.
abstract: OBJECTIVE
  To study the possibilities and outcomes for hip and femoral fractures treated with the universal Holland nail((R)).
  
  
  METHODS
  Retrospective study from November 1998 to December 2001.
  
  
  METHODS
  Department of Traumatology, Erasmus Medical Centre, Rotterdam.
  
  
  METHODS
  112 patients with 115 fractures of the proximal femur and/or the femoral shaft, due to traumatic causes or to metastatic disease.
  
  
  METHODS
  Implant possibilities of the Holland nail((R)) and observed complications.
  
  
  RESULTS
  110 patients presented for primary fracture treatment. Two patients were treated secondarily. In three patients, both femora were fractured. Nineteen patients suffered a pathological (impending) fracture. During operation we dealt with 27 minor difficulties. Postoperatively, in 80% of the cases full weight-bearing was allowed. Three patients developed wound infection. In follow-up, 14 patients were lost and two died. The remaining 77 patients (80 fractures) were available for follow-up with regard to fracture healing. Overall consolidation was achieved in 89% of the patients within 12 months. Two patients developed perforation of the femoral head, necessitating removal of the hip screws, and in two patients failure of the nail was seen. Overall, 19 patients needed a non-planned secondary intervention, of which 12 were deemed a minor procedure (e.g. 'dynamisation by distal screw removal').
  
  
  CONCLUSIONS
  The Holland nail((R)) is technically easy to use for any type of hip and femoral-shaft fracture.
authors.affiliation: Department of Traumatology, Erasmus Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Krastman
authors.forename: W N
authors.initials: WN
authors.lastname: Welvaart
authors.forename: S J M
authors.initials: SJ
authors.lastname: Breugem
authors.forename: A B
authors.initials: AB
authors.lastname: van Vugt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails / Q000009:adverse effects; D002648:Child; D004868:Equipment Failure; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005265:Femoral Neck Fractures / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D017102:Fracture Healing / Q000502:physiology; D006620:Hip Fractures / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D016474:Weight-Bearing