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SA Orthopaedic Journal

On-line version ISSN 2309-8309
Print version ISSN 1681-150X


SWANEPOEL, S et al. Intramedullary nailing of subtrochanteric femur fractures caused by low velocity gunshots. SA orthop. j. [online]. 2017, vol.16, n.3, pp.46-50. ISSN 2309-8309.

BACKGROUND: Subtrochanteric femur fractures remain challenging injuries to treat. There is paucity of literature evaluating their outcomes and complications following low-velocity civilian gunshots. The purpose of this study is to evaluate the results of intramedullary nailing of subtrochanteric femur fractures secondary to low-velocity gunshots. METHODS: A retrospective review of clinical and radiological data was performed on all patients who sustained subtrochanteric femur fractures (AO type 32C3) caused by low-velocity civilian gunshots treated at a single institution between March 2008 and December 2014. Data was analysed to determine the time to union, post-operative complication rates and patient outcomes. Radiographic evidence of healing was defined as bridging callus on three of four cortices on two orthogonal views. RESULTS: Fifty-one patients (48 men and two women) were identified. Mean age was 28 years (range 16-50 years). The predominant method of fixation was a cephalomedullary nail in 43 patients (84%), and eight patients had locking into the lesser trochanter. Thirty patients with a mean follow-up period of 3.3 weeks (0-6 weeks) were lost to follow-up. Twenty-one patients had adequate radiographic and clinical follow-up data suitable for analysis. The mean follow-up period was 24.8 weeks (range 2-40 weeks) for this group. The average time to union was 17.2 weeks (7-40 weeks). Seven fractures (37%) had delayed union. None of the patients required additional surgery. Union was achieved in all cases and no implant failure occurred. CONCLUSION: This study demonstrates that intramedullary nail fixation of subtrochanteric femur fractures caused by low-velocity civilian gunshots is an acceptable option for the treatment of these injuries with good union rates and low complication rates.

Keywords : femur fracture; subtrochanteric; civilian gunshot wound.

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