1) The treatment of lateral hip fractures
by intramedullary nail ‘‘Veronail’’: our experience
G. Caputo*, G. Fanzone, A. Rossitto
Ospedale ‘‘M. Chiello’’ ASP 4 (Piazza Armerina-Enna, IT)
Introduction Each year, the treatment of lateral hip fractures, need high economic resources. We believe that the treatment of choice should be characterized by mininvasive surgical technique, which allows a reduction of blood loss and reduction days of hospitalization, as well as the use of fixation devices good value for money. Materials and methods We treated from 2008 to 2011, 143 patients with ‘‘VeroNail’’ (mean age, 77 years). All patients were studied by X-ray examination and all hip fractures were classificated of according to AO principles. Of the 143 nails VeroNail implanted, only 4 were long nails, in the remaining cases were implanted VeroNail standard. We used the cephalic parallel sliding screws in 123 patients and the cephalic converging screws in 16 patients. Was performed in all patients the distal locking nail: we preferred the distal dynamic configuration of the system to not increase the rigidity of the system and to limit the cephalic screws cut-out. Post-operative rehabilitation was always performed to functional recovery of the limb.
Results In all cases, the clinical and radiographic healing of the fracture was achieved within 3 months after surgery. The average of hospitalization days was five. We granted immediately partial load in patients with stable fractures. Walking with partial load was granted for the unstable fractures only after three weeks. The functional recovery of fractured limb was comparable to that existing before the fracture.
Discussion Our approach was to use systems that have a second antirotational screw, to ensure more stability at the synthesis. The marketing of a nail with double-screw cephalic in parallel or converging configuration, has made the system VeroNail our reference in the treatment of extracapsular proximal fractures femur. However we have not always limited to implant only a single brand nail, but we are continuing to check the validity of the twin cephalic screws systems compared to single cephalic screw.
Conclusions Our experience with ‘‘VeroNail’’, confirms the validity of this nail for the treatment of the pertrochanteric hip fractures as well as basicervical hip fractures. This nail is suitable to the treatment of persottotrochanteric femur fractures by convergence configuration of the cefalic screws too. Less suitable for young people in the impossibility of changing and the difficulty encountered with the removal of the nail. The use of this nail is not indicated in young patients because it is impossible to change the neck-shaft angle and because it is very difficul to remove.
2) “Trattamento chirurgico delle fratture articolari dell’epifisi distale del radio scomposte volarmente”.
- Lo Scalpello; Vol. XVII, fasc. 2-3: 235-236, 2003
3) Convegno regionale Gost “Osteopatie metaboliche e alterazioni del metabolismo minerale: orientamento alla diagnosi e terapia”
Caltanissetta 15 – 16 maggio 2009
4) XX Congresso Regionale ASOTO – “Patologia dell’anca nell’adulto”
Cefalù, 21 22 ottobre 2011