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Complications Following Short Femoral Nail Fixation for Intertrochanteric Hip Fractures: A Retrospective Study
Anastasia Vasilopoulou1, Antonios Trichonas2, Konstantinos Palaiologos2
1Trauma and Orthopaedic Department, Red Cross Hospital Korgialeneio-Benakeio, Athens, Greece.
Journal of Long-Term Effects of Medical Implants
|June 6, 2024
Summary
Intramedullary nails are effective for hip fractures but can cause complications like lag screw cutout and avascular necrosis (AVN). Revision surgery is often needed for these serious issues.
Area of Science:
- Orthopaedic Surgery
- Trauma Management
- Geriatric Medicine
Background:
- Proximal femur fractures are increasing due to an aging population.
- Intramedullary nails are the preferred treatment for intertrochanteric hip fractures, offering biomechanical advantages over hip screws.
- Despite benefits, intramedullary nailing has associated complications.
Purpose of the Study:
- To investigate complications of intramedullary nailing for intertrochanteric hip fractures.
- To analyze outcomes in a major trauma center setting.
Main Methods:
- Retrospective study of 240 patients treated with intramedullary nails (Stryker Gamma3, VITUS PF Nail) from October 2020 to October 2022.
- Detailed recording of all postoperative complications.
Main Results:
- Three major complications observed: lag screw cutout (2 patients), avascular necrosis (AVN) of the femoral head (1 patient).
- Two periprosthetic fractures and one metalwork fracture were also recorded.
- All patients with cutout or AVN required revision surgery with cemented hemiarthroplasty.
Conclusions:
- Intramedullary nailing offers benefits like reduced operative time and blood loss for intertrochanteric hip fractures.
- Complications including lag screw cutout, AVN, and periprosthetic fractures necessitate complex revision procedures.
