M S G Ballal1, N Emms, G Thomas. 1. Department of Orthopaedics and Trauma Surgery, Arrowe Park Hospital, Wirral, United Kingdom. dr_moez@yahoo.co.uk
Abstract
PURPOSE: To review patients with proximal femoral nails (PFNs) in our hospital that developed complications and needed revision. METHODS: Between January 2000 and June 2006, records of 216 patients with PFN fixations for traumatic extracapsular trochanteric fractures (n=160), pathological fractures (n=23), and as a prophylactic measure for metastasis (n=33) were retrospectively reviewed. The injury mechanism, reduction technique and quality, and time to and cause of implant failure were recorded. RESULTS: 12 PFNs failed: 8 in the trauma group, 3 in the pathological group, and one in the prophylactic nailing group. Two PFNs broke at the proximal lag screw level at a later stage secondary to non-union of the pathological fractures. One broke at the level of the distal locking screw at an early stage, as the locking holes were too close to the fracture. CONCLUSION: Poorly reduced fractures tend to fail early, whereas late failures are due to non-union. Good reduction with minimal dissection, the use of appropriate nail length, and proper positioning of the nail and screws are necessary to avoid failure or revision.
PURPOSE: To review patients with proximal femoral nails (PFNs) in our hospital that developed complications and needed revision. METHODS: Between January 2000 and June 2006, records of 216 patients with PFN fixations for traumatic extracapsular trochanteric fractures (n=160), pathological fractures (n=23), and as a prophylactic measure for metastasis (n=33) were retrospectively reviewed. The injury mechanism, reduction technique and quality, and time to and cause of implant failure were recorded. RESULTS: 12 PFNs failed: 8 in the trauma group, 3 in the pathological group, and one in the prophylactic nailing group. Two PFNs broke at the proximal lag screw level at a later stage secondary to non-union of the pathological fractures. One broke at the level of the distal locking screw at an early stage, as the locking holes were too close to the fracture. CONCLUSION: Poorly reduced fractures tend to fail early, whereas late failures are due to non-union. Good reduction with minimal dissection, the use of appropriate nail length, and proper positioning of the nail and screws are necessary to avoid failure or revision.
Authors: David H Chafey; Valerae O Lewis; Robert L Satcher; Bryan S Moon; Patrick P Lin Journal: Clin Orthop Relat Res Date: 2018-12 Impact factor: 4.176
Authors: Korhan Ozkan; İsmail Türkmen; Adem Sahin; Yavuz Yildiz; Selim Erturk; Mehmet Salih Soylemez Journal: Indian J Orthop Date: 2015 May-Jun Impact factor: 1.251