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Osteosynthesis and Trauma Care 2002; 10(1): 24-26
DOI: 10.1055/s-2002-30630
Original Articles

© Georg Thieme Verlag Stuttgart · New York

Non-Pathological Proximal Femur Fractures Treated with the Unreamed Femoral Nail with Spiral Blade

P. Reynders, P. L. O. Broos
  • Department of Traumatology, U. Z. Gasthuisberg, Leuven, Belgium
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Publication History

Publication Date:
17 May 2002 (online)

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Abstract

Fifty-eight non-pathological fractures of the proximal femur treated by the unreamed femoral nail with spiral blade (UFN-SB) were reviewed prospectively with focus on the postoperative mechanical complications.
Twelve patients had Sensheimer type II A fractures, five Sensheimer type II B, twenty-nine Sensheimer type II C, six Sensheimer type III A, two Sensheimer type IV, and five Sensheimer type V.
In thirteen fractures, the UFN-SB failed before bony union. Eleven mechanical failures occurred in type II C, and two were type V fractures. Implant failure was defined as loosening, breakage or bending of the spiral blade with clear influence on the fracture alignment.
Revision surgery was necessary in five patients: two dynamic hip screws, two 95°-blade plates and one hemiarthroplasty.
The data suggest that the unreamed femoral nail with the spiral blade should not be the implant of choice for proximal femoral fractures with intertrochanteric extensions of the fracture line.

Zusammenfassung

58 nicht pathologische proximale Femurfrakturen wurden durch einen von proximal eingeschlagenen unaufgebohrten Femurmarknagel mit Spiralblatt (UFN-SB) versorgt und prospektiv unter besonderer Berücksichtigung mechanischer Komplikationen beobachtet. Bei 12 Patienten lagen Sensheimer Typ II A-Frakturen vor. 5-mal bestanden Sensheimer Typ II B-Frakturen, 29-mal Sensheimer Typ II C. 6-mal Sensheimer Typ III A, 2-mal Sensheimer Typ IV und 5-mal Sensheimer Typ V.
In 13 Fällen versagte der UFN-SB-Nagel vor Abschluss der Frakturheilung. Bei der II C-Frakturen traten 11-mal mechanische Fehler auf, beim Typ V 2-mal. Das Implantatversagen bestand in Lockerung, Bruch oder Verbiegung des Spiralblattes, jeweils mit entsprechend negativem Einfluss auf die Frakturstellung. 5 Patienten mussten revidiert werden. 2-mal war eine dynamische Hüftschraube notwendig, 2-mal eine 95° Winkelplatte sowie 1-mal eine Hemirarthroplastie (Frakturendoprothese?).
Diese Ergebnisse legen es nahe, die Anzeigestellung von unaufgebohrten Femurmarknägeln mit Spiralblatt bei proximalen Femurfraktruen insbesondere mit intertrochantärem Frakturverlauf kritisch zu überdenken.

Key words

Traumatology - Implant failure - Hip fractures - Subtrochanteric fractures - Femur fractures

Schlüsselwörter

Traumatologie - Implantatversagen - Proximale Femurfraktur - Subtrochantäre Femurfraktur

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Prof. Dr. P. Reynders

Department of Traumatology

U. Z. Gasthuisberg, Leuven

Herestraat 49

3000 Leuven

Belgium

Phone: +32-16-34 42 77

Fax: +32-16-34 46 14

Email: peter.reynders@uz.kuleuven.ac.be