A solution to z effect and lateral wall comminution in nailing of per trochanteric fractures: A retrospective study of 54 cases

Abstract

Background: Pertrochanteric femur fractures are fractures which extends from extra capsular basilar neck of the femur to the lesser trochanter. Since this region bears the maximum mechanical stress as compared to other parts of the femur it’s a site for comminuted fractures, and accounts for 10% to 34% of all hip fractures with the incidence estimated to double by 2040. In the quest for perfect implant in pertrochanteric femur fractures we have been using hip fracture nail since past 2 years for all pertrochanteric fractures in our institution. Methods: This is a retrospective study of 54 cases of pertrochanteric femur fractures operated using hip fracture nail from 2017 to 2019 in our institute. All the patients were above 55 years of age with an average age group of 67 years. We analyzed rate of union, complications and functional outcome. All the patients were followed up at 3 months interval up to 1 year. Results: Average modified Harris hip score were satisfactory in 48 patients. Average time taken for fracture union was 9 months. Conclusion: We concluded that hip fracture nail solves many a problem of earlier generation nailing systems for unstable pertrochanteric femur fractures. Our study suggests that a twin screw integrated cephalo-medullary nail system effectively prevents the z effect and provides a solution to the lateral wall comminution which is the key predictor for a revision surgery after an unstable intertrochanteric femur fracture.