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Updated: Oct 23, 2025

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Zimmer Natural Nail and ELOS nails in pertrochanteric fractures
Giuseppe Gargano1,2, Nicola Poeta1,2, Francesco Oliva1,2
1Department of Trauma and Orthopaedic Surgery, AOU San Giovanni Di Dio E Ruggi D'Aragona, Via San Leonardo 1, 84131, Salerno, Italy.
Background:
Pertrochanteric fractures of the femur in the elderly are very common. As the average age of the population increases, the incidence of such fractures also raises, resulting in high healthcare costs. The type of surgical devices employed for their surgical management influences these costs.
Methods:
A comparative clinical study was conducted on patients operated by one single surgeon between December 2018 and November 2020 in a high-volume regional referral centre. All patients who received a Zimmer Natural Nail (ZNN) or ELOS devices were included.
Results:
In 119 (66.48%) of the 179 fractures, a ZNN nail was used. Post-operatively, the TAD (tip-to-apex distance) was measured at an average value of 17.05 (4.42-41.85) mm and the CalTAD (calcar-referenced TAD) at an average of 20.76 (10.82-43.63) mm. The mean hospitalization time was 10.19 (4-22) days. In the other 60 trochanteric fractures, an ELOS nail was used. Post-operative imaging indicated a TAD of 19.65 (5.08-31.4) mm and a CalTAD of 22.86 mm (12.66-33.77). The average time of the operation was 45.82 (20-110) min. The average period of hospitalization was 10.45 (5-24) days.
Conclusion:
Both devices give similar results in terms of short-term post-operative outcome and hospitalization. The price difference between the devices does not translate in different short-term results on the operated patients.
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