Evolution of Technology

Femoral Nailing

Femoral nailing is an attractive option for the treatment of hip fractures. This is a minimally invasive technique only requiring small incisions of the skin and does not require the large dissection needed for other techniques.

A metal rod (or nail) is placed within the femur, spanning across the fractured segment and is secured into place, most of with screws. One thicker screw is placed through the femoral neck and into the femoral head near the hip joint to prevent the fracture from rotating and compress across the fracture site, and one screw is placed near the end of the rod to prevent it from migrating inside the bone.

Patients are immediately able to walk after surgery because the metal rod helps to share the load of weight through the femur. This way patients can mobilize early, prevent the development of blood clots or a pneumonia and return to their pre-injury level of function and activity.

Evolution of Procedure

Hip Fracture Surgery

The primary goals of hip fracture surgery are twofold: decrease the pain associated with the fractured femur bone, but more importantly get patients back to walking. Historically, the treatment of fractures of the femur required the use of plates and screws to stabilize the fracture. But this approach requires a larger incision and dissection and does not allow for early weightbearing because it would cause the screws and/or plate to break.

While the idea for placing an implant within the hollow canal inside a bone has been around since the 1940s, it was not until the end of the 20 th century that designs were improved on and femoral nailing became a viable and attractive option for treating hip fractures. Femoral nailing has also been shown to have shorter surgical times and lower infection rates.

Evolution of Diagnosis

Hip Fracture

Hip fractures are one of the most common surgically treated fractures of the lower extremity in the United States and are most likely to be seen in elderly people after a fall from standing. While they are low energy fractures that happen due to poor bone quality, they can prevent patients from being able to walk and can lead to blood clots of the legs or pneumonias due to the inability to sit upright.

Xrays will be taken to diagnose hip fractures and it is recommended that these fractures are treated with surgery, most preferably within 48 hours of the injury.