88.
Case series of first experience with use of the Intertan nail for all types
of proximal femoral fractures
Ann Jørgensen, Ilija Ban, Thomas Bloch, Thomas Houe, Henrik Palm
Orthopaedic Slagelse; Orthopaedic, Slagelse; Orthopaedic, Slagelse;
Orthopaedic, Slagelse; Orthopaedic, Hvidovre
Background:
Intertan is an antegrade intertrochanteric nail, designed with two
collum screws integrated with one- another. Beyond the fixed shaft-collum
angle given by all trochanteric nails this design also theoretically allows linear
intraoperative compression and rotation stability over the fracture sight. The
Intertan was introduced to our hospital in 2008 and in time used for all types of
proximal femoral fractures. Such a variety of use has to our knowledge not
been examined before.
Purpose / Aim of Study:
To evaluate the reoperation rate following Intertan
procedures performed on all types of proximal femoral fractures.
Materials and Methods:
401
hip fracture nailing procedures during 2008-11
were retrospectively identified through the booking system, of which 101 were
Intertan procedures. The surgeon on duty decided the choice of implant.
Demographic data and reoperations within 6 months were assessed from
patient records and radiographs.
Findings / Results:
Mean patient age was 71, gender rate 57F/44M and side
rate 50L/51R. 8 implants were inserted by unsupervised, 39 by supervised
junior, and 54 by senior surgeons. All but 5 patients were allowed immediate
full weight bearing. Reasons for reoperation were 8 fracture collapses, 4
hardware discomforts after healing, 2 new fractures following new traumas, 1
infection, and 2 due to suboptimal implant insertion. The overall 17%
reoperation rate was distributed on 9/60 trochanteric, 0/5 basocervical and 8/36
femoral neck fractures, among which the Garden 4 fractures had the highest
rate at 5/12.
Conclusions:
In this cohort of selected cases, our first experience indicates
that although the new Intertan features with some difficulties could be used for
all proximal femoral fractures, it does not seem to improve the reoperation
rates, except maybe for the few rotationally unstable basocervical fractures.
