Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN).
10.12671/jkfs.2007.20.1.33
- Author:
Kee Byoung LEE
1
;
Byung Taek LEE
Author Information
1. Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Anyang, Korea. btleemd@naver.com
- Publication Type:Original Article
- Keywords:
Femur;
Pertrochanteric fractures;
Proximal femoral nail;
Complications
- MeSH:
Anesthesia, Spinal;
Femoral Neck Fractures;
Femur;
Head;
Humans;
Osteonecrosis;
Periprosthetic Fractures;
Reoperation;
Skin;
Thigh
- From:Journal of the Korean Fracture Society
2007;20(1):33-39
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We analyzed the complications of femoral pertrochanteric fractures treated with proximal femoral nail (PFN®) to reduce the its complications. MATERIALS AND METHODS: We evaluated the complications among 198 patients who were treated with PFN® from June 2001 to August 2005 in our hospital. RESULTS: The complications were presented in 28 cases (14.1%). Cut-out of lag screw was in 1 case, cut-out of lag screw and antirotation screw were in 3 cases, cut-out of antirotation screw in 3 cases, of these femoral head fracture was in 1 case. Femoral neck fracture in 1 case, Osteonecrosis of femoral head in 1 case, cortical fracture during the insertion of distal interlocking screw in 1 case, breakage of drill bit intraoperatively in 1 case, fibrous union in 2 case, thigh skin irritation due to screw back-out in 3 cases, periprosthetic fractures in 2 cases, varus collapse more than 10 degrees in 4 cases, superficial and deep infections in 3 cases, breakage of nail in 1 case, varus collapse after PFN removal in 1 case, persistent thigh pain in 1 case. Of all these cases, 9 cases (4.5%) were required reoperation with general or spinal anesthesia. Complications related with screws or fracture reduction were 19 cases (9.6%) and, of these, 17 cases (89.5%) showed increased TAD (tip apex distance) or nonanatomical reduction. CONCLUSION: To reduce the complications of PFN®, we need to exact surgical technique and anatomical reduction and consider the modification of implant design to prevent of cut-out of screws.
