Role of modified Kuntscher's nail in management of subtrochanteric fractures of femur

Background : Subtrochanteric fractures of femur are a problem in management due to displacement of the fragments. Various extramedullary or intramedullary implants have been described . Methods: Eighty-five patients who had sustained 87 subtrochanteric fractures (two bilateral) that had been fixed by a modified Kuntscher's nail (K-nail) during 1992 to 2000, and were available for follow-up in 2001, were reviewed. The average age of the patients was 37.6 years (range 20 to 51 years). The standard K-nail was flattened proximally to provide rotational stability and angled laterally to prevent varus angulation. Fourty seven nails were locked proximally through the broadened eye, the rest were left unlocked. Results : After an average follow-up duration of 6.8 years (range 1.2 to 8.5 years), the results in terms of prevention of varus and rotational alignment were found to be encouraging. Conclusion : Low implant cost and the advantage of an intramedullary device make this modification even more attractive for the poor Asian patients. Locking does not influence the results significantly.