PROPHYLACTIC NAILING IN HIP FRACTURE PATIENTS WITH SEVERE OSTEOPOROSIS: MID TERM RESULTS

IntroductionIn elderly patients, the incidence of a second fracture in the contralateral hip within 2 years of a femoral neck fracture (FNF), ranges from 7 to 12%.HypothesisWe want to evaluate the safety and efficacy of the Prevention Nail System (PNS), a titanium screw with a hydroxyapatite-coated thread, developed to prevent contralateral FNFs in severe osteoporotic patients.Materials and methodsFrom September 2008 to May 2012, 80 osteoporotic FNF patients (Tscore<;−2.5) were recruited. Patients received standard care for the fractured hip and were randomized to receive either the PNS (Group A), or nothing (Group B) in the contralateral hip. DXA, CT and X-rays of the reinforced hip were scheduled at 3, 12 and 24 months postoperative.ResultsAverage follow-up was 26 months. Twenty-one patients reported secondary falls. Group A: 13 patients with 9 osteoporotic fractures (3 contralateral subtrochanteric); Group B: 6 patients with a second osteoporotic fracture (3 contralateral FNF). CT scans showed no radio...