Effectiveness of distally slotted proximal femoral nails on prevention of femur fractures during and after intertrochanteric femur fracture surgery |
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| Institution: | 1. Ümraniye Training and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey;2. Istanbul Medeniyet University, Göztepe Training and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey;1. Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway;2. Department of Clinical Medicine, University of Bergen, Bergen, Norway;1. Laboratory of Experimental Trauma Surgery, Justus-Liebig-University Giessen, 35392 Giessen, Germany;2. Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany;3. Department of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, Rudolf-Buchheim-Str. 7, 35385 Giessen, Germany;4. Institute of Medical Microbiology, University Hospital of Giessen-Marburg GmbH, Campus Giessen, 35392 Giessen, Germany;5. Department of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany;1. Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, China;2. Department of Joint Surgery, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, 215300, China;1. The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, New South Wales, Australia;2. Lions Eye Institute. Nedlands, Western Australia, Australia;3. Department of Ophthalmology, University of Western Australian, Nedlands, Western Australia, Australia;4. The School of Optometry and Vision Science, UNSW, Sydney, New South Wales, Australia;5. Tan Tock Seng Hospital, Singapore;6. The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia |
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| Abstract: | IntroductionIntra- and post-operative femoral shaft fractures related with nailing remain of concern. Although manufacturers have sought to solve the problem by providing distally slotted nails, it is not clear that these implants reduce fractures.We compare two distally slotted proximal femoral nails trochanteric nail (TRON) and proximal femur intramedullary nail (PROFIN)].Patients and MethodsThe medical records of 195 hips treated with TRONs (distally slotted in four places in the sagittal and coronal planes) and 583 hips treated with PROFINs (distally slotted in two places in the coronal plane) in two institutes were retrospectively evaluated. The inclusion criteria were follow-up for at least 6 months; pertrochanteric fractures and age over 55 years.ResultsIn total, 161 hips in the TRON group and 512 hips in the PROFIN group were included. The mean follow-up time was 28.5 (range: 6–84) months in whole group. The demographic characteristics of the groups were similar. Only 2 intraoperative shaft and 3 proximal lateral cortex fracture was detected in PROFIN group, there wasn’t any postoperative fracture. Four proximal lateral cortex and 2 femur shaft fractures were detected in TRON group (one during operation and one at postoperative 8th month after a fall at pedestrian way).ConclusionsDistal cephalomedullary nail slotting prevented intra- and post-operative femoral fractures. A distal slot 50 mm in length may increase nail elasticity and reduce nail tip stress to a greater extent than a 30-mm slot. Distal slotting in both the sagittal and coronal planes afforded no advantage compared to coronal slotting only.Level of evidenceLevel III retrospective study |
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| Keywords: | Intertrochanteric femur fracture Intramedullary nail Distal slot Femoral shaft fracture |
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