Cement augmentation of intertrochanteric fractures stabilisedwith intramedullary nail: operative technique.

The incidence of proximal femoral fractures has substantially risen in the elderly. This rise has been attributed to an increase in their life span and the underlying poor bone stock and osteoporosis.One of themain reason for revision surgery, reported to be as high as 19%, is the cut-out of the fixation device at the apex of the femoral head. Augmentation, facilitated by injecting cement (PMMA) around the apex of the proximal screw of the fixation device, is considered as a useful method with regard to the increase purchase between the bone and implant interface.The aim of this study is the description of the cement Augmentation operative technique for unstable osteoporotic intertrochanteric fractures with 1-2 femoral head screws devices. La complicanza del cut-out nel trattamento delle fratture pertrocanteriche nell'anziano con osteoporosi, descritta in letteratura con una incidenza variabile dal 9 al 14%, risulta essere un problema attuale in chirurgia ortopedica. La tecnica operatoria dell’Augmentation, intesa come supporto meccanico della sintesi interna nelle fratture pertrocanteriche, tramite cementazione con pochi millilitri di PMMA all’apice delle viti cervico-cefaliche, è stato dimostrato, in vitro ed in vivo, essere una sicura e valida metodica per scongiurare il fenomeno del cut-out.