J Korean Fract Soc.  2007 Jan;20(1):33-39. 10.12671/jkfs.2007.20.1.33.

Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN)

Affiliations
  • 1Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Anyang, Korea. btleemd@naver.com

Abstract

PURPOSE
We analyzed the complications of femoral pertrochanteric fractures treated with proximal femoral nail (PFN®) to reduce the its complications.
MATERIALS AND METHODS
We evaluated the complications among 198 patients who were treated with PFN® from June 2001 to August 2005 in our hospital.
RESULTS
The complications were presented in 28 cases (14.1%). Cut-out of lag screw was in 1 case, cut-out of lag screw and antirotation screw were in 3 cases, cut-out of antirotation screw in 3 cases, of these femoral head fracture was in 1 case. Femoral neck fracture in 1 case, Osteonecrosis of femoral head in 1 case, cortical fracture during the insertion of distal interlocking screw in 1 case, breakage of drill bit intraoperatively in 1 case, fibrous union in 2 case, thigh skin irritation due to screw back-out in 3 cases, periprosthetic fractures in 2 cases, varus collapse more than 10 degrees in 4 cases, superficial and deep infections in 3 cases, breakage of nail in 1 case, varus collapse after PFN removal in 1 case, persistent thigh pain in 1 case. Of all these cases, 9 cases (4.5%) were required reoperation with general or spinal anesthesia. Complications related with screws or fracture reduction were 19 cases (9.6%) and, of these, 17 cases (89.5%) showed increased TAD (tip apex distance) or nonanatomical reduction.
CONCLUSION
To reduce the complications of PFN®, we need to exact surgical technique and anatomical reduction and consider the modification of implant design to prevent of cut-out of screws.

Keyword

Femur; Pertrochanteric fractures; Proximal femoral nail; Complications
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