Treatment of peritrochanteric fractures with the Endovis BA cephalomedullary nail: Multicenter study of 1091 patients

Treatment of peritrochanteric fractures involves reduction and synthesis using reconstruction plates and screws, intramedullary or cephalomedullary nails, or external fixators. A new cephalomedullary nail, Endovis BA (Citieffe, Italy), made of titanium alloy implanted without reaming and is fixed with 2 cephalic screws was used to treat 1091 patients with lateral fractures of the femoral neck (AO class 31-A). The patients had a mean age of 75 years (range, 48-99 years), and 83% had one or more systemic comorbidities. Mean operative time was 35 min (range, 20-100 min), and 483 patients (44.3%) required transfusion of one or more units of blood. The nail was implanted without distal blockage in 886 patients (81.2%) and without reaming in 1081 patients (99.1%). Intra-operative complications were recorded in 28 patients (2.6%). At the 6-month follow-up, 128 patients (12%) had died from causes unrelated to the surgery. Of the remaining 963 patients, 632 (65.6%) could walk independently, 249 (25.9%) could walk with assistance, and 82 (8.5%) could not walk. Postoperative complications were recorded in 38 patients (3.5%); most common complications were cut-out (10 cases), loss of reduction (8 cases) and prominent screws (6 cases). In conclusion the Endovis BA nail seems to be a reliable choice for the treatment of lateral fractures of the femoral neck, especially considering the short operating time and low rate of complications.