Subtrochanteric femoral fractures: A case series of 194 patients treated with long and short intramedullary nails

Author:

Jannelli Eugenio1,Ghia Cristina2,Marta Medetti3,Pasta Gianluigi4,Ivone Alessandro4,Boggio Ester5,Conza Gianluca1,Zanchini Fabio1,Grassi Federico Alberto6,Mosconi Mario6

Affiliation:

1. University of Campania "Luigi Vanvitelli"

2. Orthopedic and Traumatology Clinic, Edoardo Agnelli Hospital

3. Istituto clinico San Siro, IRCCS Istituto Ortopedico Galeazzi

4. Orthopedic and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation

5. Orthopedic and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation; Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia

6. University of Pavia

Abstract

Background IM nails are the gold standard of subtrochanteric fractures management. Indications to use a short rather than a long nail remain unclear. Operative complications of subtrochanteric fractures reach up to 25%. Objective Retrospectively compare clinical and radiographic outcome of subtrochanteric fractures treated by long and short intramedullary nailing, analysing rates of complications Methods 390 patients were chosen from the archives. 194 patients were available: 70 treated with a short intramedullary nail (Group A), while 124 with long one (Group B). Radiographic evaluation at 6 and 12 months assess failure of the osteosynthesis. Clinical outcomes were the return to normal activities prior trauma and VAS scale. Group A mean age was 81.37 years, group B mean age was 78.9 years (29-99, SD: 15.38). Results Radiografic Healing was found in 66 patients (94.28%) in group A, while in 116 patients (94.54%) in group B. Pseudarthrosis was found in 4 cases (5.71%) in group A, while in 8 cases (6.45%) in group B. Implant failure occurred in 5 cases: one required revision of fixation, while 4 require hip replacement. 59 patients of group A (84.29%) returned to social life, while 102 patients (81.94%) in group B. Group A mean VAS was 1.55, Group B mean VAS was 1.49. Conclusion Comparison of the two group showed no differences. Complication percentages are in line with literature. Optimal reduction and fixation allow high percentage of healing and return to social life.

Publisher

Open Medical Publishing

Subject

Orthopedics and Sports Medicine

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