Summary
The Author has developed a modified intramedullary nail for the stabilisation of fractures in the subtrochanteric and proximal one-third of the femur. Due to its three tapered fins the rod fits well into the funnel-like medullary cavity of the proximal femur preventing varus or rotational displacement of the proximal fragment. This method has been applied in 16 cases. Its particular advantages are the chance to perform the operation closed, a short operating time and period in hospital, early weight bearing and a simple surgical technique without the need for special instrumentation, requiring little radiographic exposure during surgery. The ideal and relative indications for the application of the technique are discussed. Biomechanical tests have confirmed that the finned medullary nail is the most stable method of fixation of the fractures when compared with other alternative devices.
Résumé
L'auteur a mis au point un clou centromédullaire modifié pour l'ostéosynthèse des fractures sous-trochantériennes et du tiers supérieur du fémur. Grâce à ses trois ailettes la tige s'ajuste bien à la cavité médullaire élargie de la partie supérieure du fémur, prévenant ainsi les déplacements en varus ou en rotation du fragment proximal. Cette méthode a été utilisée dans seize cas. Ses avantages tiennent à la possibilité de réaliser l'enclouage à foyer fermé, à la brièveté de l'intervention et de l'hospitalisation, à la possibilité d'une mise en charge précoce et à sa technique simple, ne nécessitant ni instrumentation particulière ni utilisation prolongée des rayons. L'auteur discute les indications idéales et relatives de cette technique.
Les épreuves bio-mécaniques ont confirmé que ce clou à ailettes constitute la méthode de fixation la plus stable de ce type de fractures, comparativement aux autres modes d'ostéosynthèse.
Similar content being viewed by others
References
Allen WC, Burstein AH (1978) A fluted femoral intramedullary rod. J Bone Joint Surg. [Am] 32: 506–515
Boyd HD, Griffin LL (1949) Classification and treatment of trochanteric fractures. Arch Surg 58: 853–866
Fielding JW (1973) Subtrochanteric fractures. Clin Orthop 92: 86–99
Fielding JW, Cochran GVB, Zickel RE (1974) Biomechanical characteristic and surgical menagement of subtrochanteric fractures. Orthop Clin North Am 5: 629–650
Frankel V, Burstein AH (1970) Orthopedic Biomechanics. Lea and Febiger. Philadelphia
Froimson AI (1970) Treatment of comminuted subtrochanteric fractures of the femur. Surg Gyn Obstet 131: 465–472
Hartmann H (1980) Neuartige Trochanterplatte und Kompressionsplatten. Chirurg 51: 250–252
Holt EP (1963) Hip fractures in the trochanteric region: treatment with a strong nail and early weight-bearing. J Bone Joint Surg [Am] 45: 687–705
Johnson LL, Lottes OJ, Arnot JP (1968) Utilization of the Holt nail for proximal femoral fractures. J Bone Joint Surg [Am] 50: 67–78
Koch JC (1917) The laws of bone architecture. Am J Anat 21: 177–298
Leonidis S, Panagopoulos N (1974) Surgical treatment of subtrochanteric fractures. Injury 6: 70–76
Martinek H, Wielke B, Egkher E, Fasol P, Passl R, Sauer G, Spängler H (1976) Die Belastbarkeitsgrenze verschiedener Osteosynthesen pertrochanterer Oberschenkelfrakturen. Arch Orthop Unfallchir 84: 273–284
Ruszkowski I, Muftic O (1977) Modifizierter Küntschernagel zur Fixierung des proximalen Teiles des Femurs nach korrektiven Osteotomien bei Kindern. Arch Orthop Unfallchir 89: 239–244
Shelton ML (1975) Subtrochanteric fractures of the femur. Arch Surg 110: 41–48
Watson HK, Campbell RD, Wade PA (1964) Classification, treatment and complications of the adult subtrochanteric fracture. J Trauma 4: 457–480
Zickel RE (1976) An intramedullary fixation device for the proximal part of the femur. J Bone Joint Surg [Am] 58: 866–871
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Scherfel, T. A new type of intramedullary nail for the internal fixation of subtrochanteric fractures of the femur. International Orthopaedics 8, 255–261 (1985). https://doi.org/10.1007/BF00266869
Issue Date:
DOI: https://doi.org/10.1007/BF00266869