Clinical Results of Complex Subtrochanteric Femoral Fractures with Long Cephalomedullary Hip Nail.
- Author:
Kwang kyoun KIM
1
;
Yougun WON
;
Danica H SMITH
;
Gi Soo LEE
;
Hee Young LEE
Author Information
- Publication Type:Original Article
- Keywords: Femur; Subtrochanteric fracture; Long cephalomedullary hip nail
- MeSH: Classification; Dissent and Disputes; Femoral Fractures*; Femur; Follow-Up Studies; Head; Hip Fractures; Hip*; Humans; Leg
- From:Hip & Pelvis 2017;29(2):113-119
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Good results of the cephalomedullary nails have been reported in proximal femoral fractures recently. Based on length of nails and shape of screws fixed in a femoral head for proximal fragment fixation, the proper nail length was in dispute. The purpose of this study was to evaluate the clinical and radiological results of a long cephalomedullary hip nail for the treatment of comminuted subtrochanteric femoral fractures. MATERIALS AND METHODS: Twenty-one consecutive patients with severe subtrochanteric femoral fractures who had undergone intramedullary fixation using long-PFNA II between March 2010 and March 2013 were followed-up for over 12 months. Their mean age was 64.8 years old (range, 43-85 years). Sixteen of 22 cases were high energy trauma. According to Seinsheimer's classification, 5 cases were type IV and 16 cases were type V. For radiological assessment, time to union, change of neck-shaft angle, sliding length, tip-apex distance (TAD) and leg length discrepancy (LLD) were measured. For clinical evaluation, a modified Koval index was investigated. RESULTS: Mean operation time was 96 minutes. An average decrease of neck-shaft angle was 4.5°. The average sliding length of the helical blade was 4.2 mm. Average LLD was 3.0 mm, and TAD was 23.0 mm. Mean modified Koval index score at final follow-up was 4.6 points. All the 21 subtrochanteric fractures healed uneventfully on an average of 24.2 weeks (range, 18-30 weeks). CONCLUSION: Long cephalomedullary hip nail provides excellent clinical and radiological outcomes in the comminuted subtrochanteric fracture.
