[Radiographic and functional results of osteosynthesis with locked intramedulary nailing of subtrochanteric fractures of the femur].

OBJECTIVES

We evaluated the radiographic and functional results of locked intramedullary nailing in the treatment of subtrochanteric fractures of the femur.

METHODS

Nineteen patients (14 men, 5 women; mean age 51.8 years; range 20 to 87 years) underwent locked intramedullary nailing for subtrochanteric fractures of the femur. The fractures were on the right in nine patients and on the left in 10 patients. The injuries were caused by a simple fall (n=12), motor vehicle accident (n=4), falling from a height (n=2), and gun shot (n=1). Six patients had associated fractures and nine patients had preexisting medical problems. The fractures were classified according to the Russel-Taylor system. The results were evaluated according to the Harris scoring system. The mean follow-up was 25 months (range 12 to 58 months).

RESULTS

The mean operation time was 40 minutes and the mean amount of bleeding was 150 ml. Union was obtained in all the patients, occurring after dynamization in four. According to the Harris system, the results were excellent in 10 patients (52.6%), good in six patients (31.6%), moderate in two patients (10.5%), and poor in one patient (5.3%). Outcomes were adversely affected by associated fractures and preexisting medical problems. All the patients returned to daily activities in a mean of 12 weeks. At surgery, a distal fissure occurred in two patients and, postoperatively, three patients developed superficial infections at the site of distal screws.

CONCLUSION

Intramedullary nailing may be the preferred method in the treatment of subtrochanteric fractures of the femur due to high rates of union, early mobilization of the patient, short operation time, and less perioperative bleeding.