Femoral fractures in the elderly treated with an unreamed titanium nail

We present a review of 28 femoral fractures in 28 elderly patients treated with an unreamed titanium intramedullary nail (AIM femoral nail, ACE medical, Figure 1). The series included 11 male and 17 female patients with an average age of 74.5 yr (range 63.5-93 yr). One fracture was open and the rest, closed (six pathological). Average follow up was 6 months (range 4.5-21 months). Mean time to bony union was 19 weeks (+/- 3.5). The union rate was 91 per cent with two delayed unions; one was a subtrochanteric pathological fracture and the other a diaphyseal fracture. Shortening of 2 cm occurred in one patient and one had malrotation. There was no implant failure in our series either with the screws or the nails. We feel that titanium unreamed intramedullary femoral nailing is an effective way of treating subtrochanteric and shaft fractures of the femur in old and frail patients.