Surgical treatment of basicervical intertrochanteric fractures of the proximal femur with cephalomeduallary hip nails

Abstract

Objective: To study the outcome of basicervical intertrochanteric fractures of the proximal femur treated with cephalomeduallary hip nails.

Methods: The clinical outcomes of 32 cases of basicervical intertrochanteric fractures treated with cephalomeduallary hip nails from January 2008 to June 2010 were retrospectively reviewed and the progress of fracture healing and occurrence of complications recorded. The function of the hip joints was evaluated by the Harris social index 2 years postoperatively.

Results: Thirty patients were followed up until fracture union for at least 24 months. Twenty-seven fractures had healed with no loss of position by 12 months postoperatively; the remaining three had mild varus deformity of the hip joint. No patient had evidence of avascular necrosis of the femoral head. No cut out of the helical blade was visible on radiographs. The mean Harris score was 86.5 (75-96) two years postoperatively, 11 patients having excellent scores, 15 good and 4 fair.

Conclusion: Closed reduction and proximal femur intramedullary nail fixation for basicervical intertrochanteric fractures provides stable fixation and allows early exercise. It appears to have excellent outcomes in the short and medium term.