The incidence of fractures in the proximal femoral area has risen with the increasing numbers of elderly persons with osteoporosis and traffic accidents in young adults.
Fractures about the trochanteric area are classified according to the Orthopaedic Trauma Association classification system as AO/OTA 31-A, which delineates them as extracapsular fractures of the hip. These fractures are subdivided into groups A1, A2 and A3. A1 fractures are simple, two part fractures, whereas A2 fractures have multiple fragments. A3 fractures include reverse oblique and transverse fracture patterns.
There are two main types of implant available for the treatment of these fractures, namely, extramedullary and intramedullary implants [1–3]. Although the most widely used extramedullary implant is the dynamic hip screw, which consists of a sliding neck screw connected to a plate in the lateral femoral cortex, most authors have reported that this device is not suitable for AO/OTA 31-A3 reverse oblique or transverse fractures due to high incidence of fixation failures. Thus, the treatment of these unstable trochanteric femoral fractures is still challenging, and clinical reports regarding intramedullary hip nailing for reverse obliquity intertrochanteric fractures are few in number.
Features & Benefits
Fractures with bone loss
Proximal and distal fractures
The physician’s education, training and professional judgement must be relied upon to choose the most appropriate device and treatment.
Any active or suspected latent infection or marked local inflammation in or about the affected area.
Compromised vascularity that would inhibit adequate blood supply to the fracture or the operative site.
Bone stock compromised by disease, infection or prior implantation that can not provide adequate support and/or fixation of the devices.
Material sensitivity, documented or suspected.
Obesity. An overweight or obese patient can produce loads on the implant that can lead to failure of the fixation of the device or to failure of the device itself.
Patients having inadequate tissue coverage over the operative site.
Implant utilization that would interfere with anatomical structures or physiological performance.
Any mental or neuromuscular disorder which would create an unacceptable risk of fixation failure or complications in postoperative care.
Other medical or surgical conditions which would preclude the potential benefit of surgery.