O1015 LONG PROXIMAL FEMORAL NAIL FOR COMPLEX SUBTROCHANTERIC FEMUR FRACTURES

Abstract

Aim: To report our experience with a newly devised Long Proximal Femoral Nail [Long PFN] for treating complex subtrochanteric femoral fractures. The nail has the advantage of providing rotational as well as axial stability in the proximal femur with its hip pin in addition to the strong hip screw and easy operation technique. Methods: Twenty-four consecutive patients with twenty-four displaced subtrochanteric femoral fractures were treated with long PFN. The fractures were classified according to the Seinsheimer’s criteria. In 9 patients, the proximal femur had posteromedial wall comminution with displacement. The average age of the patients was 68.7 years. Closed reduction of the fracture was attempted in all cases and when it failed to achieve satisfactory reduction, a limited open reduction and cerclage cabling of the fracture was performed prior to the nailing with a particular emphasis on the postero-medial wall reconstruction. Result: The average follow up period was 49.7 weeks. All fractures in our series achieved bony union with an average time to union of 24.5 weeks. No patients had implant failure and no deep infection noted in the patients who had limited open reduction. Two patients had chest infection and one had non-fatal pulmonary embolism. Conclusion: Long PFN is a reliable implant in the treatment of complex subtro-chanteric fractures. Posteromedial wall reconstruction of the proximal femur is mandatory when treating sub-trochanteric fractures with Long PFN to avoid mechanical failure and non-union.