Abstract

The Purpose of this study was to evaluate biomechanical factors working around hip which leads to implant failure. Material & Methods: This was an observational study. All 20 cases below 75 years of age with proximal femoral fracture [fracture Inter-trochanteric & Sub-trochanteric included] fixed with PFN irrespective of the centre where surgery was performed attending routine out-door of Department of Orthopaedics, Shridevi Institute of Medical Sciences & Research Hospital, Tumkur, India with implant failure were registered for the study. Results: In our study we registered total of 20 cases with mean age of registered cases was 64.86 + 8.50 years. 15 patients (75%) were male and 5 (25%) were females. Except 3, all cases of implant failure in our study were categorized as unstable type according to EVAN’s & A.O. classifications preoperatively. Out of 20 cases registered, pattern of implant failure in our study were 6 cases (30%) had implant failure pattern of Z- effect, 5 cases (25%) had implant failure pattern of reverse Z-effect; 2 (10%) had breakage of nails; 1 cases (5%) had both screw breakage with varus collapse; 3 (15%) had single upper proximal screw breakage; & 3 cases (15%) were associated with spiral fracture femur just distal to the tip of PFN. Conclusion: Proper implant selection is critical and should be done on an individualized patient and fracture pattern basis. Poor surgical technique, implant-related issues, delayed fracture union, and poor patient compliance and health status alone or in combination can lead to breakage of the implants requiring challenging treatment options. Prevention of such catastrophic complications is crucial for the patient’s health and quality of life. Biomechanical study of the broken implant may provide useful information regarding failure causes and guide future treatment. Surgeons and mechanics should work hand in hand for implants evolution in order to optimize patient treatment

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