English

Abstract

BACKGROUND: Proximal femoral nail is commonly recommended as treatment of choice for unstable and reverse oblique intertrochanteric fracture in view of superior biomechanics and prevention of varus collapse associated with Dynamic hip screw. Although in stable fracture types DHS is still being preferred as the treatment modality of choice. Proximal femoral nail owing to better biomechanics, less complications can still be used as the method of choice in stable fracture pattern as well. The aim of this study is to evaluate the results of PFN nail in stable intertrochanteric fracture and include evaluation of the mean operative time, amount of blood loss, complications and functional status of the patient. MATERIALS AND METHODS: In this study 30 patients presented to Orthopedics Department Hamidia Hospital Bhopal with stable intertrochanteric fracture were treated with proximal femoral nail. All patients were followed up for a period of 1 year and functional outcome assessment including amount of shortening, neck-shaft angle, Harris hip score was noted. RESULTS: At the time of final follow-up, all 30 patients showed union with average Harris hip score of 86.6 (range 62-94).14 patients had excellent score, 9 patients had good score, 5 patients had fair score and 2 patients had poor outcome. Mean neck shaft angle achieved post-reduction was 131.4 degrees and at final follow-up was 128.4 degrees. Limb length discrepancy was assessed in the final follow-up with average shortening of 5 mm and 4 patients had shortening above 1.5 cm. Average blood loss was 80 ml, the mean operative time was 65 minutes. Complications were seen in 3 cases with one case of local wound infection, one of screw cut-out and one of screw penetration. CONCLUSION: With proper technique PFN gives excellent results with less blood loss and shorter incision with less soft tissue trauma are added advantages which ultimately lead to less morbidity and early mobilisation of the patient and early return to normal routine activities. Most of the complications can be avoided by proper placement of the screw and maintaining proper neck-shaft