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 .
Is the Proximal Femoral Nail a Suitable Implant for Treatment of All Trochanteric Fractures?
We review ed 155 consecutive patients who were treated with a proximal femoral nail from 1997 to 2001 to determine the rate of implant specific complications . Results were stratified according to fracture type and surgeon experience to determine which problems occurred in these groups . One year postoperative followup was available for 129 of 132 surviving patients ( 98 % ) . Failure of fixation occurred in three patients ( 2 % ) , and a femoral shaft fracture occurred in one patient ( 0.7 % ) . Fixation failures included one cutout , one delayed fracture healing , and one lateral displacement of the antirotation screw . The total reoperation rate was high ( 12 % ) mainly because of hardware removals , which occurred in 13 patients ( 8.6 % ) . Stratification of results showed that hematomas and iliotibial tract irritation occurred more commonly with lesser surgical experience . General complications and intraoperative problems were seen more often with subtrochanteric fractures . Because the high reoperation rate with the proximal femoral nail is a concern , extramedullary devices continue to be the preferred implants for treatment of stable trochanteric fractures . The low rates of femoral shaft fractures and failure of fixation suggest the proximal femoral nail is useful for treatment of unstable trochanteric and subtrochanteric fractures . Level of Evidence : Therapeutic study , Level IV ( case series ) . See the Guidelines for Authors for a complete description of levels of evidence
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 .