[The proximal femoral nail (PFH)--another alternative for osteosynthesis of trochanteric fractures].

The aim of the study was to test a new intramedullary implant PFH-Medin on internal fixation of trochanteric fractures. The basic group comprised 35 patients (average age 79.2 years). Indicated for the surgery were patients with all types of trochanteric fractures, i.e. 13 stable (AO 31A1), 15 unstable (AO 31A2) peritrochanteric fractures and 7 intertrochanteric (AO 31A3) fractures. Final outcomes were evaluated in 21 patients with the minimal follow-up of 6 months. From the viewpoint of the type of the fracture 9 cases were stable peritrochanteric, 7 cases unstable peritrochanteric and 5 intertrochanteric fractures. Duration of surgery was measured from the incision until wound closure and in the whole group of 35 patients it was on average 50 min. (range, 25-90 min.). X-ray exposure was recorded including the period necessary for the reduction of the fracture and was on average 80 sec. (range, 25-120 sec.). In the whole group we encountered only two complications. The first complication resulted from the insertion of the distal locking screw outside of the nail and the patient healed without problems. The second case involved aseptic necrosis of the femoral head eight months after the surgery and five months after the fracture had healed. All 21 patients followed up minimally for sixth months healed in anatomical position.