A Study On Surgical Management Of Unstable Intertrochanteric Fractures Using Proximal Femoral Nail

Abstract

Abstract Fractures around the trochanteric area of the femur are among the most frequent fractures encountered in orthopaedics and also among the most distressing injuries of the elderly. A burgeoning population and increased life expectancy have resulted in a rise in these types of fractures .Several implants have been designed for the treatment of these fractures. In this study we analyze the functional and radiological outcome of unstable inter-trochanteric fractures fixed with proximal femoral nail. Methods: This is a prospective study. 30 patients with inter-trochanteric fractures treated by proximal femoral nail from December 2015 to December 2017 were included in the study. We analyzed these 30 patients for functional and radiological out come and complications. The criteria’s for the assessment of efficiency of surgical technique included duration of surgery, number of intraoperative complications, blood loss and radiographic screening time. Clinical assessment includes post operative walking ability, hip and knee function, fracture union time, and implant bone interaction by Hips Harris Score Results: The fracture union rate was 86.6 % and the average union time was 13.5 weeks. According to Hip Harris Score (Modified), over all 7 % of patients had outstanding results, 47 % of patients had good results, 33 % of patients had fair results and only 4 cases i.e., 13 % of patients had poor results. Conclusion: The result of our study shows that proximal femoral nail is an effective device for the fixation of inter-trochanteric fractures of femur with good functional and radiological outcome. We conclude that the PFN is an highly accepted minimally invasive implant for unstable proximal femoral fractures but future modification of the implant to avoid Z-effect phenomenon, careful surgical technique and selection of the patients should further reduce its complication rate.Keywords: Inter-Trochanteric Fracture, Proximal Femoral Nail, PFN