Clinical, functional and radiological outcome of unstable intertrochanteric femur fracture treated with proximal femur nail

Abstract

Objective: To determine the clinical, functional and radiological outcome of unstable intertrochanteric femur fractures treated with proximal femur nailMethods: The study is a prospective study on 20 patients to analyse clinical, functional and radiological outcome of unstable intertrochanteric femur fractures treated with proximal femur nail conducted in the Department of Orthopedics at Stanley medical college, Chennai from June 2018 to August 2020. Functional outcome was assessed using Harris hip score.Results: 20 patients of unstable intertrochanteric fracture were treated surgically with proximal femur nail and the results were functionally and radiologically analysed. Patients were followed up from 11months to 22 months and mean follow up in months was 15.9 ± 2.73. Mean Harris hip space at 3months was 73.85 ± 3.4, Mean Harris hip score at 6months was 85.15 ± 2.66. Radiological Fracture union was noted between 12-16 weeks and mean time for union was 12.90 ± 1.4 weeksConclusion: Intramedullary nailing with the PFN has distinct advantages over DHS like shorter operating time and lesser blood loss for unstable trochanteric fractures. Early mobilization and weight bearing is allowed in patients treated with PFN thereby decreasing the incidence of bedsores, uraemia and hypostatic pneumonia. The incidence of pre-operative and postoperative planning and correct technique, adequate reaming of femoral canal, insertion by hand and meticulous placement of distal locking screws. PFN is a significant advancement in the treatment of unstable trochanteric fractures which has the unique advantage of closed reduction, preservation of fracture haematoma, less tissue damage during surgery, early rehabilitation and early return to work.