Early complications associated with cephalomedullary nail for intertrochanteric hip fractures

Use of cephalomedullary devices for pertrochanteric fractures has been associated with complications of cutout, fracture distal to the tip of the implant, infection, and hardware failure. The goal of recent design changes (a trapezoidal shape of the proximal device, with interdigitation of the cephalocervical screws) in cephalomedullary nails was to improve fracture fixation and stability of pertrochanteric fractures. This is a retrospective review of the first 127 surgeries using this new cephalomedullary nail to review early complications seen with this device.

A review of early complications (cutout, infection, fracture distal to the tip, fracture collapse, and hardware failure) for 100 patients who met inclusion criteria was performed.

Postoperative mechanical complications included six (6%) patients with significant collapse of the femoral neck, six (6%) fractures distal to the implant (short nail only, n = 75), one (1%) cutout, four (4%) infections, and one (1%) implant breakage. The implant breakage occurred at the screw-nail interface.

In our study population, we found this newer cephalomedullary device had complications similar to those reported with devices in previous studies.