Osteosynthesis of Per- to Subtrochanteric Femur Fractures with the PLATON Nail: Early Results

Abstract

Various intramedullary nail systems have been established for the treatment of per- and subtrochanteric femoral fractures. This study focused mainly on the advantages and disadvantages of implementing a new intramedullary nail system named the PLATON nail. One hundred and thirty patients who had per- and subtrochanteric femoral fractures were treated using the intramedullary PLATON nail over the period from September 2001 until May 2003. The median age of these patients was 76 (range: 39-98) years with a predominance of female patients (3 : 1). The classification of the fractures was determined with regard to Evans and the AO guidelines. Patient compliance was recorded, as well as clinical and radiographic examinations for each patient. The 130 operations were conducted by 28 surgeons. The mean time of surgery was 54 minutes. A closed reduction of the fracture preceded the locking nail implantation in 94 % of the cases. The insertion of the nail was found to be easy by 93 % of the surgeons. A lateral movement of the femoral lag screw due to displacement was seen in 5 cases. Infection and haematoma were observed in 5 patients. Compared to other similar implants, the cut-out rates, secondary fractures, implant failures and the need for revision were lower. On the other hand, the incidences of infection, haematoma and irritation are comparable to other implants. While the differences between the PLATON nail and other types of systems were moderate in many respects, a visible reduction of cut-out and secondary fractures were indicated by this study.

Key words

Trochanteric fracture - subtrochanteric fracture - femur fracture - PLATON nail - intramedullary nail

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