The clinical evidence behind the current implants used for proximal femoral fractures is weak considering the number of implants used worldwide .
Sporadic evaluation is not sufficient to identify long term problems .
INTRODUCTION Evaluation of the long-term performance of  implants used in trauma surgery relies on post-marked clinical studies since no registry based implant assessment exists .
The purpose of this study was to evaluate the evidence of performance of implants  currently used for treating proximal femoral fractures ( PFF ) in Denmark .
Use of the gamma3™ nail in a teaching hospital for trochanteric fractures: mechanical complications, functional outcomes, and quality of life
Background Trochanteric fractures are common fractures in the elderly . Due to characteristic demographic changes , the incidence of these injuries is rapidly increasing . Treatment of these fractures is associated with high rates of complications . In addition , the long-term results remain poor , with high morbidity , declines in function , and high mortality . Therefore , in this study , complication rates and patients ’ outcomes were evaluated after fixation of geriatric trochanteric fractures using the Gamma3 ™ nail . Methods Patients aged 60 years old or older , with pertrochanteric and subtrochanteric femoral fractures , were included . Patients with polytrauma or pathological fractures were excluded . Age , sex , and fracture type were collected on admission . In addition , data were recorded concerning the surgeon ( resident vs. consultant ) , time of operation , and local or systemic perioperative complications . Complications were also collected at the 6- and 12-month follow-ups after trauma . Barthel Index , IADL , and EQ-5D measurements were evaluated retrospectively on admission , as well as at discharge and during the follow-up . Results Ninety patients were prospect ively included between April 2009 and September 2010 . The patients ’ average age was 81 years old , and their average ASA score was 3 . The incision/suture time was 53 min ( 95 % CI 46–60 min ) . Hospital mortality was 4 % , and overall mortality was 22 % at the 12-month follow-up . Eight local complications occurred ( 4 haematomas , 1 deep infection , 1 cutting out , 1 irritation of the iliotibial tract , 1 periosteosynthetic fracture ) . The incidence of relevant systemic complications was 6 % . Forty-two percent of the patients were operated on by residents in training , without significant differences in duration of surgery , complication rate , or mortality rate . The Barthel Index ( 82 to 71 , p < .001 ) , IADL ( 4.5 to 4.3 , p = .0195 ) and EQ-5-D ( 0.75 to 0.66 , p = .068 ) values did not reach pre-fracture levels during the follow-up period of 12 months . Conclusion The results showed a relatively low complication rate  using the Gamma3 ™ nail , even if the nailing was performed by residents in training .  The high mortality , declines in function , and low quality of life could probably be attributed to pre-existing conditions , such as physical status . In summary , the Gamma3 ™ nail seems to be a useful implant for the nailing of trochanteric fractures , although further studies are necessary comparing different currently available devices
The clinical evidence behind the current implants used for proximal femoral fractures is weak considering the number of implants used worldwide .
Sporadic evaluation is not sufficient to identify long term problems .
INTRODUCTION Evaluation of the long-term performance of  implants used in trauma surgery relies on post-marked clinical studies since no registry based implant assessment exists .
The purpose of this study was to evaluate the evidence of performance of implants  currently used for treating proximal femoral fractures ( PFF ) in Denmark .