Trochanteric femoral nail

Introduction Unstable intertrochanteric hip fractures can be difficult surgical challenges. Screw and side plate devices reliably stabilize stable fracture patterns [1,2], but unstable fractures require a mechanically optimized device and better implant purchase in the femoral head. These fractures have been more prone to implant failure with standard devices [3, 4]. The trochanteric femoral nail (TFN) is a helical blade device which has fins that compact the cancellous bone as it is inserted into bone and may provide improved fracture stabilization characteristics [5, 6]. A retrospective study of 273 patients with intertrochanteric hip fractures who were treated with a TFN was conducted at two institutions between 2001 and 2005. Patients underwent closed fracture reduction using traction and manipulation techniques. When the reduction was unacceptable as determined by the surgeon, adjunctive percutaneous reduction techniques were utilized. Implants were placed percutaneously, and compression of the fracture was performed in the majority of fractures. Precise measurement of movement of the blade within the femoral head and the nail was performed on all radiographs according to a previously described technique (Fig 1) [6]. The amount of telescoping was then measured as the lateral prominence of the blade lateral to the edge of the nail. X-ray measurements were made immediately postoperatively, at six weeks postoperatively, and at subsequent follow-up.