Reversed Femoral Nail

OrthoLimited Reversed Femoral Nail

Introduction

The incidence of fractures in the proximal femoral area has risen with the increasing numbers of elderly persons with osteoporosis and traffic accidents in young adults.

Fractures about the trochanteric area are classified according to the Orthopaedic Trauma Association classification system as AO/OTA 31-A, which delineates them as extracapsular fractures of the hip. These fractures are subdivided into groups A1, A2 and A3. A1 fractures are simple, two part fractures, whereas A2 fractures have multiple fragments. A3 fractures include reverse oblique and transverse fracture patterns.

There are two main types of implant available for the treatment of these fractures, namely, extramedullary and intramedullary implants [1–3]. Although the most widely used extramedullary implant is the dynamic hip screw, which consists of a sliding neck screw connected to a plate in the lateral femoral cortex, most authors have reported that this device is not suitable for AO/OTA 31-A3 reverse oblique or transverse fractures due to high incidence of fixation failures. Thus, the treatment of these unstable trochanteric femoral fractures is still challenging, and clinical reports regarding intramedullary hip nailing for reverse obliquity intertrochanteric fractures are few in number.