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Abstract
Subtrochanteric fracture account for a proximately 10-34% of all hip fractures.(6) The treatment of these fractures continues to present a challenge to orthopedic surgeon due to anatomical and biomechanical features including associated comminution concentration of high stresses and strong deforming forces due to muscular attachment.(34)
In adults, non-surgical treatment has little or no place due to high rate non-, delayed and malunion and complication of recumbence. Extramedullary devices showed limited success with frequent implant failure, excessive blood loss non-, and malunion. On the intramedullary devices are more favored bimechanically, have a high rate of union and less complications.(32)
The aim of this work was to study the results of treatment of unstable subtrochanteric fractures of the femur (Seinshimer type III, IV, V) by the second generation cephalomedullary (reconstruction) nail.
This study included 20 patients with traumatic subtrochanteric fracture of the femur. The age of the patient ranged from 19 to 70 years with a mean value of 38.6±17.3 years. 16 patients were males (80%) and 4 patients were females (20%). The mechanism of injury varied, 9 fractures were caused by road traffic accident (45%), 5 fractures (25%) caused by simple fall, 4 fracture (20%) were caused by falling downstairs and two fractures (10%) were caused by falling from a height. All cases were classified according to Seinsheimer classification, 11 fractures (55%) were Seinsheimer type V, 6 (30%) were Seinshimer type III, while 3 (15%) were Seinshimer type IV.
The duration of follow up ranged from 8-20 months with average of 15.6±3.56 months. The net result were assessed clinically and radiologically. Clinical assessment was done following Kyle’s criteria. Fifteen patients (75%) achieved excellent result, and 3 patients (15%) achieve good result, while 2 patients (10%) achieved fair result.