title: Use of femoral nail with spiral blade in subtrochanteric fractures.
abstract: OBJECTIVE
  The aim of this study was to evaluate the outcome of acute subtrochanteric fractures managed with intramedullary nail and spiral blade fixation of the proximal fragment.
  
  
  METHODS
  Charts of 33 patients (17 males and 16 females) with acute subtrochanteric fractures operated with intramedullary nail and spiral blade at our institution between March 2006 and February 2011 were retrospectively reviewed. The most common (67%) mechanism of injury was ground-level fall, predominantly involving elderly patients. Results were evaluated in terms of union time, implant failure rate, infection rate and functional outcome.
  
  
  RESULTS
  Mean duration of surgery was 2.4 hours and average length of hospital stay was 7 days. Mean radiological healing time was 16 weeks. Good healing occurred in 31 (94%) patients within 6 months of surgery. Uneventful healing occurred in 28 (85%) patients and 3 (9%) had delayed healing requiring dynamization in two patients and bone grafting in one. Implant failure occurred in 2 (6%) patients within 2 months of index surgery requiring repeat surgery. One (3%) patient had varus malunion.
  
  
  CONCLUSIONS
  Intramedullary nailing with spiral blade is a good option for acute subtrochanteric fractures with promising results. We think that this is a superior device compared to conventional methods of fixation for subtrochanteric fractures.
authors.affiliation: Department of Orthopedic Surgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Masood
authors.initials: M
authors.lastname: Umer
authors.affiliation: Department of Orthopedic Surgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Haroon
authors.initials: H
authors.lastname: Rashid
authors.affiliation: Department of Orthopedic Surgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Idrees
authors.initials: I
authors.lastname: Shah
authors.affiliation: Department of Orthopedic Surgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Irfan
authors.initials: I
authors.lastname: Qadir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011859:Radiography; D012189:Retrospective Studies; D016474:Weight-Bearing; D055815:Young Adult