148.
A novel technique: Preliminary clinical results of cement
augmentation of intertrochanteric fractures stabilized with an
intramedullary nail
Flemming Hansen, Mette S. Skjaerbaek
Department of Orthopedic Surgery The Regional Hospital of Viborg;
Department of Orthopedic Surgery, The Regional Hospital of Viborg
Background:
Osteosynthesis of intertrochanteric fractures in patients with
poor bone quality is a challenge for orthopedic surgeons, implant failure and
especially cut-out are well known complications.
Purpose / Aim of Study:
The aim of this study is to investigate effects and
complications when using augmentation of intertrochanteric fractures
stabilized with an intramedullary nail.
Materials and Methods:
6 (5
female) patients with a mean age of 88 years
(
range 68-98) comprised the population. All patients had an intratrochanteric
fracture and were pre- or peroperative considered having a high risk for cut-
out. In the period of November 2011- April 2012 all patients underwent
osteosynthesis with a Proximal Femoral Nail Antirotation (PFNA) with
perforated blade cement augmentation. In all cases high-viscosity cement was
used, which was injected through the perforated blade to enlarge the load-
bearing surface and to diminish the stresses on the trabecular bone. Cement
augmentation was in these cases considered being a salvage procedure. The
mean time of postoperative observation was 92 days (range 10-178).
Findings / Results:
No postoperative complications have been observed. For
this short period of observation no cut-out or migration of the blade has been
observed in the population.
Conclusions:
Cement augmentation of intertrochanteric fractures stabilized
with an intramedullary nail in patients with a high risk for cut-out seems to be
a serviceable technique. Studies are needed to determine when this technique
is advisable.
