The telescoping Pugh nail in the surgical management of the displaced intracapsular fracture of the femoral neck.

In 187 intracapsular fractures of the femoral neck at St. Luke's Hospital from 1930 to 1971, the rates of nonunion and avascular necrosis have decreased with improved treatment methods. Since 1963, the Pugh nail has been used in displaced fractures. Two hundred and fifty six patients have been reviewed at an average of 2 1/2 year following injury, 90% (230) united and 17% (40) developed avascular necrosis. Twenty four of the 40 patients with necroses were asymptomatic and were considered to have satisfactory results. Therefore, 84% of the 256 patients had good or excellent results. The dangers and complications inherent in prosthetic replacement when used in potentially active patients as opposed to the paucity of these complications observed after use of the Pugh nail make nailing the preferred method of treatment.