ABSTRACT
Evaluation of the gliding nail in the elderly patient with unstable fracture of the proximal femur. Primary aims of the study were the description of surgical procedure, the specific complications, postoperative pain, recovered mobility and social status after nailing procedure. The observation period of this prospective non-randomized observational cohort study was from 10/97 to 07/00. 121 patients (90 female, 31 male) with unstable femoral fracture were included. Data evaluation included type of fracture, surgical data, procedure specific complications and pre and post surgical development (pain, mobility and social status). The evaluation of the outcome was performed at least 3 months (median 10.4 months) after surgical intervention by telephone-interview. A subgroup of 20 patients was re-examined. 24 A1-, 65 A2-, 16 A3-, 11 subtrochanteric and 5 other fractures were stabilized with a gliding nail. The mean time of surgery was 77 minutes. In 15 out of 121 patients complications lead to a second surgical intervention. In the follow-up examination we were able to obtain following findings: 33.9 % vs. 56.2 % (preoperative) of patients were self-contained. The need for professional care was unchanged. 23.5 % vs. 58.7 % (preoperative) showed unlimited mobility. 20.3 % vs. 12.8 % complained light or moderate pain. According to our experience the gliding nail is a safe and minimal invasive system with a low complication rate. In consideration of patient based outcome the gliding nail shows good results compared to other treatment options. For the given reasons the authors prefer the gliding nail as treatment of choice for proximal femoral fractures.
