Abstract
Background: Proximal femur nailing has become the treatment of choice in intertrochanteric femur fractures. There are different views regarding the use of distal locking in these fractures. It is said that the distal locking does not only provide rotational and axial stability but also improves the fracture healing ; However, reports of implant failure , implant breakage , stress fracture at nail tip or at distal screw insertion site , thigh pain ,cortical hypertrophy and difficulty in distal screw insertion are among the possible complications that can be encountered. In our study we investigated the outcome of omitting the distal screw in intertrochatric fractures.
 Materials and Methods: 19 patients with intertrochanteric femur fractures were treated with proximal femoral nail without distal locking. Distal locking was omitted when a tight fit of PFN was felt in the medullary canal by the operating surgeon. The results were evaluated with Modified Harris Hip Score.
 Results: 19 patients were followed up clinically and radiologically for 2 years.
 Conclusions: Distally unlocked proximal femoral Nail is an effective treatment modality with minimal complications in treatment of only STABLE intertrochantric fractures.
 Keywords: PFN, without distal lock, intertrochanteric fractures
Highlights
The intertrochantric fractures continue to pose a major challenge to the orthopaedic surgeons
It is said that the distal locking does provide rotational and axial stability and improves the fracture healing ; reports of implant failure, implant breakage, stress fracture at nail tip or at distal screw insertion site, thigh pain,cortical hypertrophy and difficulty in distal screw insertion are among the possible complications that can be encountered
Materials and Methods: 19 patients with intertrochanteric femur fractures were treated with proximal femoral nail without distal locking
Summary
The intertrochantric fractures continue to pose a major challenge to the orthopaedic surgeons. The intramedullary implants have a huge variety of choices with the earliest being the short gamma nail followed by the trochanteric gamma nail and long gamma nails. The most common of them is proximal femoral nails with two lag screws in neck of femur. Common to all of these intramedullary implants is the distal fixation advised into the femoral shaft. Proximal femur nailing has become the treatment of choice in intertrochanteric femur fractures. Materials and Methods: 19 patients with intertrochanteric femur fractures were treated with proximal femoral nail without distal locking. Distal locking was omitted when a tight fit of PFN was felt in the medullary canal by the operating surgeon. Conclusions: Distally unlocked proximal femoral Nail is an effective treatment modality with minimal complications in treatment of only STABLE intertrochantric fractures.
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