[Rotationally stable, intramedullary osteosynthesis of proximal extra-articular femur fractures]

Abstract

Aim: The proximal femur nail (PFN) and the gliding nail (GLN) are two modern procedures available for intramedullary osteosynthesis of proximal extra-articular femur fractures; they allow a rotationally stable fixation of the proximal fragment. In a comparative analysis of complications, both methods should be evaluated.

Methods: A comparative analysis of both procedures is presented in a prospective clinical study design. The treatment of 240 consecutive patients (124 PFN/116 GLN) with an average follow-up term of 10.2 months is analysed.

Results: Both PFN and GLN give rise to head perforations (4.8% and 2.6%), dislocations of material (0.8% and 0%), intraoperative femoral shaft fractures (0.8% and 2.6%), pseudarthrosis (0% and 0.9%) and fractures of material (0.8% and 0%) in the way of complications as well as wound-healing impairments (9.7 % and 5.2 %) and iatrogenic complications such as false placement of the osteosynthesis material and errors in reposition (0.8% and 4.3%).

Conclusion: The gliding nail osteosynthesis yields a more favourable complication profile with regard to specific osteosynthesis-caused complications (6.0%) and wound-healing impairments (5.2%) in comparison with the PFN osteosynthesis (7.3% and 9.7%, respectively). Especially the cut-out rate of the GLN (2.6%) is lower than that of the PFN (4.8%).