This study examined the clinical and radiologic results of a proximal femoral nail (PFN) used to treat an intertrochanteric fracture of the femur in elderly people more than 90 years of age.

Between January 2005 and December 2008, 20 patients over 90 years old with an intertrochanteric fracture were treated with a PFN. Among them, 16 patients (mean age, 93.9 years; 13 females and 3 males) were followed up for a minimum of 6 months. Clinically, the modified Koval index was evaluated. Radiological bony union and complications were evaluated from the plain X-ray film.

The average modified Koval index decreased from 3.1 before surgery to 1.8 after surgery. Only 5 cases could return to their pre-injury status. Radiologic bony union was achieved after an average of 8.2 weeks and there were no complications, such as non-union and femoral head perforations.

Thirty one percent of patients older than 90 years and treated for an intertrochanteric fracture with a PFN had recovered to their pre-injury ambulatory status. However, all cases showed bony union and no complications. Overall, PFN might be a good treatment option for intertrochanteric fractures in elderly people older than 90 years.