EVALUATION OF NECK SHAFT ANGLE AS A PREDICTOR OF CUT-OUT FAILURE IN PERTROCHANTERIC FRACTURES- AN OBSERVATIONAL STUDY

Abstract

Introduction: Femoral trochanteric fractures are extremely common fractures of old age. Due to the fracture, there is a change in the neck shaft angle (NSA) which if not restored can lead to further disability [1]. In this study, we aim to evaluate the neck shaft angle as a predictor of cut out failure in patients with pertrochanteric fractures after surgical xation by various xation methods. Materials and methods: A total of 100 patients with pertrochanteric fractures were enrolled in the study, who underwent surgical xation with either of three 3 methods- DHS/PFN/PFN-A. Patients were followed up at 6 weeks, 3months and 6 months. Neck shaft angle (NSA) of the normal side was calculated on pre-operative x-rays and of affected side on post operative radiographs. Results: The mean NSA of normal side (N) and operated side (O) across various xation methods in our study was as follows- DHS- Normal side(N)-127.890, Operated side(O)- 130.80; PFN- N-126.60, O-128.50; PFN-A- N-126.330, O-127.40. In all three groups, the fracture was xed in valgus position. 6 cases of cut-out failure observed in the study, 4 among the DHS group and 2 among the PFN group. The mean NSA on operated side, mean difference between normal and operated side, change at 6 weeks, 3 months and 6 months was signicantly more among DHS group compared to PFN and PFN-A groups.