Functional Outcome of Long Proximal Femoral Nail Versus Short Proximal Femoral Nail in Peri-Trochanteric Fractures in Elderly Patient

Abstract

Background: Intertrochanteric fractures account for 5% of all hip fractures and 35–40% of these fractures are unstable three or four part fractures. Operative treatment is the best option in most of the trochanteric fractures. Evolution of intramedullary devices is a result of dissatisfaction with the extra medullary devices in intertrochanteric unstable fractures. Intramedullary nailing, with less operative time and less operative blood loss allows early weight bearing with less resultant shortening on long term follow up. Our main aim was to compare the effectiveness and drawbacks of short proximal femoral nail (PFN) versus long PFN in the management of peri-trochanteric fractures. Materials and Methods: This study was randomized, time bound, hospital based study conducted in a tertiary hospital, between April 2019 to April 2022. The study included 41 cases of unstable peri-trochanteric fractures divided into two groups. Patients of Group-I were operated with Short PFN and Group-II were operated with Long PFN by standard technique. Intraoperative parameters, post-operative data and events were noted. During follow-ups, patients were assessed by clinico-radiological evaluation and Harris hip score. Results: Total of 41 patients of peri-trochanteric fracture have been included in study out of which 24 belonged to Group-I and were operated with short PFN and rest 17 were of Group-II operated with long PFN. Though there was no significant difference in results of two Groups but use of Long PFN was found to be advantages over Short PFN in terms of the less postoperative complications, less mean time of union and better lower extremity functional scores. Conclusion: In our short term results, it was evident that the use of Long PFN has advantages over Short PFN in terms of the less postoperative complications, less mean time of union and better lower extremity functional scores. A study with a larger sample size would have made a better assessment of this surgical intervention.