Unstable intertrochanteric fractures treated with the Variwall reconstruction nail.

Forty consecutive patients with unstable intertrochanteric fractures were treated with the Variwall reconstruction nail. Twelve of these had subtrochanteric extensions to their fractures, while most were highly comminuted grade 5 fractures. This nail was found to be relatively easy to use with a mean operative time of 58 min. Mean follow up was 5.8 months. Clinically, 86 per cent had occasional pain or none at all. There were no external rotation deformities, and only one case of shortening. Radiologically there were no non-unions and no case of shaft fractures. Failure occurred in one case, but in the remaining 39 no varus collapse occurred. In conclusion this method of fixation in unstable intertrochanteric fractures provides the necessary stability to give good results.