C. Garnavos et al., The treatment of difficult proximal femoral fractures with the Russell-Taylor reconstruction nail, INJURY, 30(6), 1999, pp. 407-415
Citations number
13
Categorie Soggetti
Aneshtesia & Intensive Care
Journal title
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
The outcome of 30 proximal femoral fractures and pathological lesions in 29
patients treated with the Russell-Taylor reconstruction nail are reported.
Four patients had fractures involving both the femoral neck and shaft (seg
mental). Fifteen patients had extensive comminuted fractures of the proxima
l femur and ten patients underwent nailing because of pathological fracture
s (one bilateral).
In nineteen operations there were technical difficulties, nail insertion an
d proximal interlocking being the commonest. In the elderly there was a hig
h post-operative complication rate. Three nails needed to be revised for fa
ilure of fixation. On review, all patients under sixty years of age regaine
d full mobility and returned to their pre-fracture level of activities. Pat
ients with per-trochanteric fractures over the age of sixty had less favour
able results. No cancer patient returned to their prefracture mobility leve
l.
The Russell-Taylor reconstruction nail proved to be useful in the treatment
of segmented and, in a lesser degree, pathological fractures. However, the
surgical technique is demanding and there is a high incidence of post-oper
ative complications in the patients over the age of sixty. (C) 1999 Elsevie
r Science Ltd. All rights reserved.