For operative treatment of trochanteric femoral fractures extramedullary or intramedullary stabilization options exist. The intramedullary systems especially proximal femoral nail (PFN) presents biomechanical advantages compared to existing conventional systems.

This prospective study was performed to understand the clinical results after 57 patients having trochanteric femoral fractures managed with the AO/ASIF PFN from January 2003 to March 2004. There were 11 male and 46 female patients and the mean age was 74.7. The most fractures (73.7%) were unstable according to AO/ ASIF classification. The patients were preoperatively evaluated as ASA grade 3 or 4. The operation was performed within 6 days after the injury. The patients were followed up for a minimum of 6 months. Immediate full weight bearing was permitted in 47 patients.

Six patients died due to cardiopulmonary complications within 3 months after the operation. Of the surviving 51 patients 7 had cut-outs because of using too short proximal gliding screws. In remaining 43 patients fractures united within 4 months. The patients were evaluated by Salvati and Wilson hip function scoring system. At the final follow up 72 % of the patients had score more than 20 points (out of 40 points).

In conclusion PFN is useful and minimal invasive device in the treatment of trochanteric femoral fractures. Femoral nail positioning is critical but biomechanically stable construct can be performed with careful management and early weight bearing is allowed.