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BIOMET^® RETROGRADE INTRAMEDULLARY NAIL FOR TREATMENT OF FEMORAL SHAFT FRACTURES AND FEMORAL FRACTURES BELOW EXISTING HIP IMPLANTS IN ELDERLY PATIENTS.

Dept of Trauma & Orthopaedics, Southport and Ormskirk NHS Trust

Purpose of study: To evaluate the results Biomet® Retrograde Closed Intramedullary nailing in the treatment of femoral shaft fractures and femoral fractures below a pre-existing hip implant in elderly patients.

Patients and Methods: 25 patients were treated with closed Biomet® Retrograde Femoral Nail between February 2003 and January 2004. Eight of these had occurred below a previous hip implant. There were 19 female patients and 6 male with a mean age of 72 years. Mechanism of injury, demographics and AO fracture pattern were recorded. Pre-fracture mobility, operative details, post-operative management, complications if any, was noted. Time to clinical and radiological union, outcome using the Wilde modification of the Neer scoring system after mean follow-up of 1 year was evaluated.

Results: 2 patients were lost to follow-up and 4 patients died following unrelated medical conditions. 19 patients were available for final review. Most patients had an excellent outcome with a mean clinical and radiological union at around 15.8 weeks (range 11–20 weeks). 4 patients had backing out of a distal locking screw, which were removed. There were no implant failures. 15/19 patients achieved their pre-injury mobility status.

Conclusion: We conclude that displaced fractures of the femur and those below a hip implant can be effectively managed with closed Biomet® Retrograde Femoral intramedullary nail. Surgery is less traumatic, safe, and allows early mobilization, resulting in a good functional recovery.

Correspondence should be addressed to Mr Bimal Singh, c/o BOSA at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE