Management of femoral fractures with an interlocking nail system in patients with age-related complicating factors Experience of 25 cases.

The experience of a femoral interlocking nail system (Grosse-Kempf, Howmedica) in 25 patients with osteoporosis or osteomalacia is reviewed. The mean age was 76 years. Almost all the patients (20) were female. Nineteen fractures were due to falls, 6 were sustained in road traffic accidents; 15 involved the femoral shaft, 8 were subtrochanteric and 2 were supracondylar. Torsional fractures were most common (17 pts.) followed by bending fractures (7 pts.) and multi-fragment fractures (1 pt.). Closed procedures were used in 18 patients; 7 patients underwent open reduction. Static interlocking was done in most cases (20). The Wittmoser table for patient positioning and fracture reduction proved to be convenient, but its use depends on the fracture site. Considering the patients' age as well as the high age-related short-term mortality and associated morbidity clinical follow-up data are not significant. The material was, therefore, analyzed with a view to pinpointing potential problems related to osteoporosis or osteomalacia. Technical problems during surgery were identified in a surprisingly large number of cases.