Subtrochanteric femoral fractures: A case series of 194 patients treated with long and short intramedullary nails

• Published in: Orthopedic Reviews 2022-10, Vol.14 (6), p.38613-38613
• Main Authors: Jannelli, Eugenio, Ghia, Cristina, Marta, Medetti, Pasta, Gianluigi, Ivone, Alessandro, Boggio, Ester, Conza, Gianluca, Zanchini, Fabio, Grassi, Federico Alberto, Mosconi, Mario
• Format: Article
• Language: English
• ISSN: 2035-8164; 2035-8237; 2035-8164
• DOI: 10.52965/001c.38613

BackgroundIM nails are the gold standard of subtrochanteric fractures management. Indications to use a short rather than a long nail remain unclear. Operative complications of subtrochanteric fractures reach up to 25%. ObjectiveRetrospectively compare clinical and radiographic outcome of subtrochanteric fractures treated by long and short intramedullary nailing, analysing rates of complications. Methods390 patients were chosen from the archives. 194 patients were available: 70 treated with a short intramedullary nail (Group A), while 124 with long one (Group B). Radiographic evaluation at 6 and 12 months assess failure of the osteosynthesis. Clinical outcomes were the return to normal activities prior trauma and VAS scale. Group A mean age was 81.37 years, group B mean age was 78.9 years (29-99, SD: 15.38). ResultsRadiografic Healing was found in 66 patients (94.28%) in group A, while in 116 patients (94.54%) in group B. Pseudarthrosis was found in 4 cases (5.71%) in group A, while in 8 cases (6.45%) in group B. Implant failure occurred in 5 cases: one required revision of fixation, while 4 require hip replacement. 59 patients of group A (84.29%) returned to social life, while 102 patients (81.94%) in group B. Group A mean VAS was 1.55, Group B mean VAS was 1.49. ConclusionComparison of the two group showed no differences. Complication percentages are in line with literature. Optimal reduction and fixation allow high percentage of healing and return to social life.