A Prospective Type of Study Comparing Functional and Radiological Outcome Between the Use of Long and Short Proximal Femoral Nail in Treating Patients with Intertrochanteric Femur Fractures

Abstract

Objectives To assess the functional and radiological outcome of long and short PFN for treating intertrochanteric femur fractures. Material and Methods A prospective hospital-based study was conducted on 60 patients in a tertiary hospital between May 2022 and June 2023, which were randomized into Group A (patients treated with short PFN) and Group B (patients treated with long PFN) using a computer-based table of random numbers. Patients were followed up by 12 days one, three, and six months. Functional outcome was assessed in terms of Harris Hip Score (HHS), and radiological outcome was measured in terms of time of union, complications, and fracture alignment. Results The majority of patients were between 60 and 65 years old. The most common cause of the mode of injury was trivial falls (65.00%). Mean HHS score after 6, 12, 16, and 24 weeks for Group A and B was 75.96 and 76.25, 81.16 and 82.52, 84.01 and 86.23 and 88.94 and 90.11, respectively. Mostly, complication was found in Group B (16.67%) compared to Group A (13.33%). Duration of surgery was 71.4 minutes for Group A and 90.6 minutes for Group B. Mean radiological time to union for group A and B was 16.4 and 17 weeks, respectively. Conclusion PFN is a highly efficient implant, irrespective of length, used in the fixation of intertrochanteric femur fractures falling into the category of AO/OTA 31-A1.31-A2. Short PFN has an advantage in terms of decreased operative time C-arm exposure, whereas long PFN should be preferred in elderly patients due to the high chances of osteoporosis, as it splints the entire length of the diaphysis, preventing stress riser and incidence of peri-implant fracture.