Treatment of intracapsular fractures of the femoral neck with a biaxial proximal femoral nail

Abstract

Intracapsular fractures of the femoral neck are mostly treated using individual cancellous screws or a dynamic hip screw in combination with anti-rotational cancellous screws. The goal of this study was to evaluate the possibility of using proximal femoral nails for the surgical stabilisation of intracapsular fractures of the femoral neck. A total of 58 patients (30 male, 28 female) were evaluated in a retrospective study after a minimum postoperative follow-up of 24 months. The average length of time after surgery was 33.1 months. According to the AO classification, the following numbers of type 31B intracapsular fractures of the femoral neck were included in the study: by number, 20 cases of type 31B1, 12 cases of type 31B2 and 26 cases of 31B3. The biaxial proximal femoral nail (Targon PF, B. Braun, Aesculap(R), Germany) was the tested implant and was inserted using standard surgical techniques. No complications in healing were noted in 48 patients (82.8% of the study group) 2 years following injury. The most frequent complication found was avascular necrosis of the head in seven patients (12.1%). Pseudoarthrosis formation was seen in two patients (3.4%), and other severe peroperative complications were observed in two other patients (3.4%). Reoperations were indicated in five patients, all of whom received a total hip endoprosthesis. We did not observe any refracture in the area of the implant. After 12 months 83% of the patients stated that they felt no or little pain. The results of our study have proven that the Targon PF biaxial proximal femoral nail may be used in treating intracapsular fractures of the femoral neck.