Trochanteric fixation nail advanced with helical blade and cement augmentation: early experience with a retrospective cohort

Eur J Orthop Surg Traumatol. 2021 Feb;31(2):259-264. doi: 10.1007/s00590-020-02762-8. Epub 2020 Aug 17.

Abstract

Intra-articular screw cut-out is a potential complication of intertrochanteric femur fracture fixation with a cephalomedullary nail. Cement augmentation of fixation in the proximal segment offers the prospect of increased stability and fewer complications, but clinical experience with non-resorbable cement is limited. To determine the handling properties and efficacy of this new technique, we performed a retrospective propensity-matched cohort of forty-four geriatric intertrochanteric femur fractures treated with a cephalomedullary nail with (n = 11) or without (n = 33) augmentation with non-resorbable cement injected into the proximal segment. In the patients treated with cement augmentation, at minimum 3-month follow-up, there were no instances of intra-articular cut-out, and no increase in re-operation compared to conventional fixation. Cement augmentation appears to be safe and effective in geriatric intertrochanteric femur fractures to mitigate risk of cut-out.

Keywords: Cement augmentation; Cephalomedullary nail; Hip fracture.

MeSH terms

  • Aged
  • Bone Cements / therapeutic use
  • Bone Nails
  • Femur / diagnostic imaging
  • Femur / surgery
  • Fracture Fixation, Intramedullary*
  • Hip Fractures* / diagnostic imaging
  • Hip Fractures* / surgery
  • Humans
  • Retrospective Studies

Substances

  • Bone Cements