Treatment with locking intramedullary nailing for intertrochanteric fracture of femur: application of a new guide awl with a distal positioner

Abstract Background The use of interlocked intramedullary nail has become the preferred method of treatment for intertrochanteric fracture of the femur. This study explored a new guide awl with a distal positioner assisting the guide wire insertion and opening canal, and verification the accuracy and security of our new guide awl.Methods 42 patients with intertrochanteric fracture treated by locking intramedullary nailing were retrospectively analyzed. Three patients with insufficient follow-up were excluded from analysis. 19 patients underwent the operation using the new guide awl, the other 20 patients in the control group were operated with the help of the conventional guide apparatus. Describe the new guide awl with a distal positioner usage in the operations. Operation time, the success rate of one-time insertion, fluoroscopy time, blood loss and bone healing time were recorded.Results 42 patients (25 males and 17 females) were treated with Gamma 3 and PFNA with the help of the new guide awl with a distal positioner or the conventional conventional guide apparatus. The surgical time in new guide awl group was significantly shorter compared to the control group. The success rate of one-time needle insertion in the new guide apparatus group was 89.5%, which was higher than the 65% of the control group. The fluoroscopy time in new guide apparatus group is obviously lower than in the control group. There was no significant difference in intraoperative blood loss and bone healing time.Conclusion The new guide awl with a distal positioner we designed could reduce the difficulty in opening the femur for inserting the interlocked intramedullary nail. It is especially suitable for obese patients.