Functional and clinical evaluation of intramedullary osteosynthesis with intraheal™ proximal femoral nail, advanced in unstable peritrochanteric fractures

Abstract

Background: Cephalomedullary nailing for peritrochanteric femoral fractures is widely popular owing to low risk for perioperative morbidity. The evaluation of outcomes of peritrochanteric fracture fixation has usually relied upon objective measures. The purpose of the present study is functional and clinical evaluation including complications after intraHeal™ Proximal Femoral Nail Advanced for fixation of peritrochanteric fractures. Methods: We conducted a single center study through our post market surveillance project including 468 patients (range 26-93 years, mean age 81 years) with unstable peritrochanteric fractures (AO/OTA 31-A2, 31-A3) treated with intraHeal™ Proximal Femoral Nail Advanced. Functional evaluation was done using Harris hip score, parker score, range of motion, leg length, body mass index, neck-shaft angle and grade of osteoarthritis hip at various stages of follow up. Clinical assessment of bony union and complications in perioperative and postoperative period was also considered. Results: Radiographic union was achieved at an average 3 months in 94.5% of cases, with satisfactory reduction in 84.6% of cases. According to the Harris Hip Score 83% had excellent or good results. Parker score averaged 6 (between 6 and 8). In 36 cases postoperative complications were recorded, of which 13 required major or minor surgical procedure. 38 Patients were excluded from study due to death within 1 year of surgery. Conclusion: The intraHeal™ Proximal Femoral Nail Advanced is an excellent alternative in treatment of all types of unstable peritrochanteric fractures. This study emphasizes the importance of acceptable anatomical reduction in anteroposterior and the lateral projection in reducing the risk of cut-out failure.