[Rotationally stable, intramedullary osteosynthesis of proximal extra-articular femur fractures].
OBJECTIVE
The proximal femur nail (PFN) and the gliding nail (GLN) are two modern procedures available for intramedullary osteosynthesis of proximal extra-articular femur fractures; they allow a rotationally stable fixation of the proximal fragment. In a comparative analysis of complications, both methods should be evaluated.


METHODS
A comparative analysis of both procedures is presented in a prospective clinical study design. The treatment of 240 consecutive patients (124 PFN/116 GLN) with an average follow-up term of 10.2 months is analysed.


RESULTS
Both PFN and GLN give rise to head perforations (4.8% and 2.6%), dislocations of material (0.8% and 0%), intraoperative femoral shaft fractures (0.8% and 2.6%), pseudarthrosis (0% and 0.9%) and fractures of material (0.8% and 0%) in the way of complications as well as wound-healing impairments (9.7 % and 5.2 %) and iatrogenic complications such as false placement of the osteosynthesis material and errors in reposition (0.8% and 4.3%).


CONCLUSIONS
The gliding nail osteosynthesis yields a more favourable complication profile with regard to specific osteosynthesis-caused complications (6.0%) and wound-healing impairments (5.2%) in comparison with the PFN osteosynthesis (7.3% and 9.7%, respectively). Especially the cut-out rate of the GLN (2.6%) is lower than that of the PFN (4.8%).
Suckel
A
A
Orthopädische Universitätsklinik mit Poliklinik, Tübingen. Andreas.Suckel@med.uni-tuebingen.de
Münst
P
P
Mocke
U
U
D000328:Adult; D001858:Bone Nails / Q000706:statistics & numerical data*; D005260:Female; D005264:Femoral Fractures / Q000453:epidemiology* / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D016896:Treatment Outcome