The classic nail in the therapy of trochanteric fractures.A prospective, controlled study

Arch Orthop Trauma Surg. 1999;119(5-6):308-14. doi: 10.1007/s004020050416.

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.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Nails* / economics
  • Costs and Cost Analysis
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Intramedullary / adverse effects
  • Fracture Fixation, Intramedullary / instrumentation*
  • Fracture Fixation, Intramedullary / methods
  • Fracture Healing / physiology
  • Hip Fractures / diagnostic imaging
  • Hip Fractures / mortality
  • Hip Fractures / surgery*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiography
  • Range of Motion, Articular
  • Survival Rate
  • Treatment Outcome