The AO/ASIF-proximal femoral nail (PFN): a new device for the treatment ofunstable proximal femoral fractures

Currently available intramedullary devices for the treatment of unstable pe rtrochanteric femoral fractures are technically demanding and show a consid erable failure rate due to their massiveness and the persistent rotational instability of the head-neck fragment. The Arbeitsgemeinschaft fur Osteosyn thesefragen (AO/ASIF) therefore designed a new intramedullary device, the p roximal femoral nail (PFN), which during a handling study was tested in 4 E uropean clinics. Within one year 191 proximal femoral fractures were treated with the PFN. A fter a follow up period of at least 4 months technical failures (poor reduc tion, malrotation or wrong choice of screws) were seen in just 4.6% of the cases. One patient showed a cut-out of the implant but there were no mechan ical failures (bending, breaking of the implant) or ipsilateral fractures o f the femoral shaft at the tip of the implant. It is therefore concluded th at the results of this new implant compare favourably to the currently avai lable implants for the treatment of the unstable pertrochanteric femoral fr acture. (C) 1999 Elsevier Science Ltd. All rights reserved.