Observational Retrospective and Prospective Study on the Treatment of Femoral Fractures With EBA2

Observational Retrospective and Prospective Study on the Treatment of Lateral Proximal Femoral Fractures With Medical Device EBA2

This is an observational, retrospective and prospective study where subjects who have undergone surgery with EBA2 medical device for lateral proximal femoral fractures will be followed for data collection since the day before their surgery (retrospectively) until day 180 after surgery (retrospectively and prospectively).

This study is aimed at collecting data from patients who have already been treated with EBA2 nail. Data collection will cover the details of the fracture and surgery (from which the retrospective nature of the study), as well as details of follow up visits after surgery that patients routinely carry out up to 6 months (from which the prospective nature of the study).

The study will be conducted in three clinical sites in Italy.

EBA2, the technological evolution of Endovis BA, is now available. The device was developed in conformity with Regulations 93/42/CE and 2007/47/CE, it has the CE trademark and it is registered in the Italian National Registry of Medical Devices. EBA2 has the unique features described below:

• it is undersized compared to other nails in commerce, both proximal and distal, to further facilitate the insertion into the bone. The undersizing is aimed to reduce the stiffness of the stem. In particular, the biological nail-bone interaction will be improved as a consequence of lower shear stresses on the frontal plane;
• it is made entirely of titanium. The choice of such a material is aimed to create a flexible means of synthesis that minimizes the differences with the healthy bone mechanical properties and reduces complications in the process of fracture healing;
• it is a dual-lag screw system that provides appropriate guidance to the sliding of the fractured extremities and an improved stability. It is effective to limit torsional instability of the femoral head, both during the intervention, by the action of tightening of the screw itself, and during the healing period due to improved bearing capacity towards multidirectional loads;
• the associated surgical instruments are simple; the low number of pieces and their ease of use made the success even of the previous version.

The aim of the present observational study is to collect data that confirm for EBA2, the technological evolution of Endovis BA, the performance and tolerability proved in the previous trial. In addition, given the increasing importance that good quality of life represents in elderly, objective of this observational study is to verify the general satisfaction of the patient with lateral proximal femoral fractures treated with EBA2.

In order to evaluate subject's walking ability after the surgical insertion of EBA2, only subjects who could walk independently before of the fracture will be included in this observational study.

Inclusion Criteria:

• Subjects of both genders, aged ≥ 60;
• Subjects with diagnosed lateral proximal femoral fractures who have undergone surgery with EBA2 nail;
• Subjects with type 31A1, 31A2 or 31A3 fractures;
• Subjects able to walk independently (with or without walking aids) before the fracture;
• Subjects who sustained a low energy injury within 72 h prior the surgery;
• Subjects who received a perioperative antibiotic therapy;
• Subjects who received antithrombotic prophylaxis for 5 weeks;
• Subjects who underwent rehabilitation procedure for 30 days at least;
• Subjects who have been mobilized in the 2nd operation day;
• Subjects able to attend the scheduled visits and to follow the instructions given by the physician;
• Subjects who have given their written informed consent.

Exclusion Criteria:

• Subjects with rheumatoid arthritis;
• Subjects with fractures due to metastasis;
• Subjects with fractures operated 72 h after the traumatic event;
• Subjects with previous ipsilateral hip or femur surgery;
• Subjects with ASA Physical Status Classification Class 5;
• Subjects with Karnofsky performance status scale before fracture ˂ 80;
• Subjects who have shown hypersensitivity to any of the components of EBA2;
• Concomitant use of any other surgical device for the femoral fracture.