IPT Long Nail System® (230 mm) for Osteosynthesis of Femoral Subtrochanteric Fractures

Abstract

No outstanding fixation method for subtrochanteric fractures of the femur has been available. In recent years, intramedullary fixation with a long femoral nail has yielded good clinical results. However, the long proximal femoral nail system requires accurate fluoroscopic techniques for distal screw insertion.
We have been treating femoral subtrochanteric fractures with the IPT Long Nail System® (230 mm), a device that enables a surgeon to insert the distal screw without a fluoroscope. Here we report our initial experience with the IPT Long Nail System® for treatment of femoral subtrochanteric fractures.
Between November 2010 and March 2012, we operated on 14 patients (5 males and 9 females) with femoral subtrochanteric fractures using the IPT Long Nail System® (230 mm). Their mean age was 80.8 years (range, 45-90 years). The average follow-up period was 11 months (range, 9-18 months). The average operation time was 81.5 min (range, 35-130 min), and the average bleeding volume was 192 ml (range, 50-650 ml). Before injury, the patients' activities of daily living (ADLs) were : walking unaided 8 patients, walking with a cane 3 patients, and wheelchair 3 patients. Bone union was obtained in 11 patients, and after surgery all were able to regain their previous ADL abilities.
As surgery with the IPT Long Nail System® (230mm) is easy, patients suffer less surgery-related stress. We agree with previous authors that the 230-mm nail length is satisfactory for treating femoral subtrochanteric fractures.