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 Helical Blade Nailing Superior to Locked Minimally Invasive Plating in Unstable Pertrochanteric Fractures?
Background Technical advancements have produced many challenges to intramedullary implants for unstable pertrochanteric fractures .  Helical blade fixation of the femoral head has the theoretical advantages of higher rotational stability and cutout resistance and should have a lower rate of reoperation than a locked plating technique . Questions / purpose sWe asked whether ( 1 ) helical blade nailing reduces the rate of reoperation within 24 months compared with locked plating and ( 2 ) any of various preoperative , intraoperative , or postoperative factors predicted failure in these two groups . Methods We prospect ively enrolled 108 patients with unstable pertrochanteric fractures in a surgeon-allocated study between November 2005 and November 2008 : 54 with percutaneous compression plates ( PCCP ) and 54 with proximal femoral nail antirotation ( PFNA ) .  We evaluated patients regarding reoperation , mortality , and function .  Seventy-four patients had a minimum followup of 24 months ( mean , 26 months ; range , 24–30 months ) . Results We found no differences in the number of reoperations attributable to mechanical problems in the two groups : PCCP = six and PFNA = five . Despite a greater incidence of postoperative lateral wall fractures with helical blade nailing , only postoperative varisation of the neck-shaft angle and tip-apex distance ( 33 mm versus 28 mm ) predicted reoperation . Mortality and function were similar in the two groups . Conclusions Our data suggest unstable pertrochanteric fractures may be fixed either with locked extramedullary small-diameter screw systems to avoid lateral wall fractures or with the new intramedullary systems to avoid potential mechanical complications of a broken lateral wall . Tip-apex distance and preservation of the preoperative femoral neck-shaft angle are the key technical factors for prevention of reoperation . Level of Evidence Level III , therapeutic study . 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 .