Treatment of the Intertrochanteric Femoral Fracture with Proximal Femoral Nail: Nailing Using the Provisional K-wire Fixation

ABSTRACT

PURPOSE: To evaluate the efficiency of provisional K-wire fixation in intertrochanteric fractures treated with proximal femoral nail (PFN). MATERIALS AND METHODS: Twenty seven patients (by AO/OTA classification, A1 8 cases, A2 19 cases) were treated with PFN with percutaneous reduction and provisional K-wire fixation, and followed a mean 24.5 months. The adequacy of fracture reduction was assessed by Fogagnolo's classification and reestablishment of bone-to-bone contact with the medial anatomy. Functional results were evaluated by postoperative complications, Jensen's method and Harris hip score (HHS). RESULTS: In all cases, the bone-to-bone contact with the medial anatomy was reestablished by percutaneous reduction and examination of Fogagnolo's classification showed a good reduction. The technical complications and error of starting point were not occurred. The mean HHS was 76.5 and means Jensen's grade was 2.1 grades. Complications included excessive sliding in 1 case and early cutting-out of screw in 1 case. CONCLUSION: The provisional K-wire fixation in trochanteric fracture treated with PFN had an advantage in preventing technical complications because it facilitates a nail insertion in ideal position.