The algorithm of proximal femoral nailГлавная » Блог » The algorithm of proximal femoral nail

The algorithm of proximal femoral nail use for surgical treatment of trochanteric fractures

A.V. Kalashnikov, V.D. Malyk, Y.O. Stavinskyy, Y.M. Litun

Problems Of Trauma Injuries And Osteosynthesis, SI ‘‘The Institute for Traumatology and Orthopedics’’ by the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine, 2 Traumatology And Orthopedics, Poltava Regional Clinical Hospital, Poltava, Ukraine

Introduction: 59 per cent of all femur fractures are trochanteric fractures, and most of them happen to elderly and old people suffering from various concominant chronic somatic diseases.

Materials and methods: We analysed the results of treatment of 94 patients suffering from trochanteric fractures, who underwent treatment by proximal femoral nail. The IM nailing was performed according to the developed algorithm based on the following criteria: AO fracture type, existence of severe concominant injuries, presence of systemic osteoporosis. Depending on these factors we made static or dynamic IM nail locking, or used no distal cortical screws at all.

Thus, in cases of A1 fractures with undamaged trochanteric outer wall distal cortical screws are needless. A2 fractures are unstable, fragmented, and both cortical screws should be inserted. A3 fractures have only rotational instability, and require only one cortical screw insertion into the lower part of oval hole.

Results: Results of treatment have been monitored for up to two years. Using the algorithm we increased by 27.4 per cent the good results of treatment and social adaptation of our patients and by 9.3 per cent decreased the amount of dissatisfactory results compared to the control group.

Conclusion: The developed approach to treatment of the patients suffering from different types of trochanteric fractures promoted improving the results of treatment and further rehabilitation, and facilitated social adaptation of the patients.

Disclosure: No significant relationships.