Pugh nail system as a form of treatment for fractures of the proximal femur.

A retrospective study of the results of treatment of 177 patients who had sustained a fracture of the proximal femur was undertaken. The social background, type of injury, operation performed, duration of stay after operation, mortality and morbidity were recorded and compared with the results published by other workers. It is concluded that the Pugh sliding nail system adequately fixes most fractures of the proximal femur. It allows early postoperative mobilization and discharge to the home environment for most patients. The overall mortality and morbidity compares favourably with results published for the dynamic compression screw. Treatment of the elderly patient with a displaced subcapital fracture of the femoral neck remains a problem, due to the high incidence of failure of fixation. It may be that for this group of patients a primary hemiarthroplasty is the treatment of choice. A prospective study to resolve this issue is required. The cost of a Pugh nail is considerably less than that of a dynamic compression screw.