Functional and radiological outcome of pertrochanteric fractures treated with proximal femoral nailing in post-menopausal women, age >60 years

Abstract

Pertrochanteric fractures (intertrochanteric and subtrochanteric) are one of the common fractures encountered in general population especially with post-menopausal women following a fall due to high energy trauma requiring immediate and active intervention. The main benefit of Proximal Femoral Nailing is being a closed technique offering an excellent reduction at the fracture site and adequate strength for weight bearing even in unstable hip fractures. This intramedullary device is proven to be biomechanically superior to DHS which is an extra medullary device in the treatment of Pertrochanteric fractures. The objective of this study is to analyse and evaluate the functional and radiological outcome of Pertrochanteric fracture treated with proximal femoral nail. A study population was selected and was carried out with a total of 30 patients (post-menopausal) treated with proximal femoral nail from the year 2015-2017. All the patients were selected based on inclusion criteria such as closed fractures of less than 3 weeks and age above 60 years. The appropriate selected patients were assessed both clinically and radiologically at regular intervals of 4wks, 8wks, 12wks, 16wks and 20wks. The functional outcome was assessed using Harris Hip score. From our selected study sample we found majority of the patients were unstable fractures (70%) and others were stable fractures (30%). Based on the union, 50 % of patients showed full union by 12 to 15 weeks and 35 % showed full union by 17 to 20 weeks. We had 85% of the patients with good anatomical results and 50% of the patients with excellent functional results. PFN is a quite safe, well tolerated and effective instrumentation useful in the treatment of all Pertrochanteric fractures. Being a closed intramedullary procedure early mobilization and rehabilitation is possible with early restoration of premorbid functions.