The objective of internal fixation of pertrochanteric fractures is anatomic reduction and stable internal fixation, immediate patient mobilization, and early return to function. Yet, there are technical challenges in the reduction and fixation of pertrochanteric fractures:
Up to 15% incidence of varus, cutout and hardware failure
All patients with varus are at increased risk for cutout, or hardware failure
Patients lose strength, power, and function and may not return to pre-injury ambulatory level of function.
Improvements are Needed in Pertrochanteric Fracture Repair
EPIX VAN™ is the only patient-specific dynamic hip nail that can be adjusted in situ, and may solve these challenges. VAN (Variable Angle Nail) gives the surgeon freedom to infinitely adjust guidewire placement into the center-center position in the femoral head. EPIX VAN enables in situ movement of the lag screw to achieve anatomic reduction of the fracture. This may improve patient outcomes by avoiding varus, cutout and hardware failure.
One nail for all neck-shaft angles, one set of instruments for all cases
Allows perfect center-center position
Dramatically reduces nail inventory by a factor of three
The fracture is not reduced before reaming or implant is placed
Too lateral nail entry
Oval insertion channel causing lateral nail position
Effect of varus on the patient:
Shortened distance from greater trochanter to Iliac wing
Decrease abductor muscle strength due to shortened muscle state
Increase risk of:
cut-out and implant-bone failure
hardware failure due to longer lever arm
Possible increased need for assistive devices
Need for hip replacement if there is cutout or implant failure
Conversely, when a hip fracture is accurately reduced, the result is an excellent outcome with near normal function and reoperation rates less than 1%.
The EPIX VAN System enables optimal center-center position every time. The variable angle nail is an intramedullary rod with a pivoting 11mm lag screw.
The EPIX VAN is actuated from the top of the nail in situ or on the back table using the EPIX DTS™ (Dynamic Targeting System).