Abstract
Purpose: Describe our experience with our new approach for treating displaced subcapital femoral fractures in our active patients.
Materials and Methods: From August 2005 till January 2008, 79 active patients were treated for displaced Sub-capital Femoral fracture by close reduction and internal fixation with Short Trochanteric Antegrade Nail (T.A.N.) (Smith& Nephew).
Mean age 74.5 (range 38–93),
Partial weight bearing began 0–4 weeks post operation and Full Weight Bearing 4–8 weeks post operation.
Patients were evaluated at 1,2,6,12& 24 months after the operation.
Results: All patients returned to walk on their feet.
The patients were scored by modified lower extremity questionnaire with mean results 4.1 (scale of 1–5, 1-poor, 5-excellent).
There were no cases of implant failure. No cases of infections.
Two patients had a cut-out of the implant and two other patients had a nonunion of the fracture. Those 4 patients (5.06%) were converted to a THR.
There were no cases of avascular necrosis.
Conclusions: Our complications rate for displaced sub-capital fractures treated by C.R.I.F. were lower than that reported for the alternative treatment modality. Our findings show that these fractures can be treated with a high rate of success by closed reduction and internal fixation with an intramedullary biaxial fixation in all age groups. With this simple and minimally invasive operation and the nail’s biaxial angular stability, we can achieve stable fixation.
This procedure offers several advantages over hemiarthroplasty, by lowering the risk of immediate complications such as prolonged anesthesia, bleeding, infection, periprosthetic fractures and dislocations. Furthermore, the use of the short TAN preserves the femoral head and the normal anatomy in active patients in order to avoid the late complications of hemiarthroplasty.
Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Email: office@efort.org
