Proximal femoral nail for treatment of trochanteric femoral fractures.
OBJECTIVE
To report outcomes of 87 consecutive patients treated with a proximal femoral nail (PFN) for trochanteric femoral fractures.


METHODS
17 men and 70 women aged 58 to 95 (mean, 85) years with trochanteric femoral fractures underwent PFN fixation using an intramedullary nail, a lag screw, and a hip pin. Fractures were classified according to the AO system; the most common fracture type was A2 (n=45), followed by A1 (n=36) and A3 (n=6). The position of the lag screw within the femoral head was measured. The lateral slide of the lag screw after fracture consolidation was measured by comparing the immediate postoperative and final anteroposterior radiographs.


RESULTS
90% of lag screws were placed in an optimal position. The length of lateral slide of the lag screw in stable A1 fractures was significantly less than that in unstable A2 fractures; it was over 10 mm in 7 of 45 patients with A2 fractures. Cut-out of lag screw did not occur, suggesting that free sliding of the lag screw facilitates direct impaction between fragments.


CONCLUSIONS
A PFN is useful for the treatment of trochanteric femoral fractures.
Morihara
T
T
Department of Orthopaedic Surgery, Kyoto Prefectural Yosanoumi Hospital, Kyoto, Japan. toru4271@koto.kpu-m.ac.jp
Arai
Y
Y
Tokugawa
S
S
Fujita
S
S
Chatani
K
K
Kubo
T
T
D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D016896:Treatment Outcome