Management of comminuted intertrochanteric fractures with TFN -A (Trochanteric Femoral Nailing - Advanced) in elderly patients – A prospective study

Abstract

Background: A study was undertaken to evaluate the surgical management of intertrochanteric fractures with Trochanteric Femoral Nailing – Advanced design as a fixation device, and to determine the rate of union, complications, operative risks and functional outcome of intertrochanteric fractures in elderly patients. Materials and Methods: The fractures were classified according to BOYD and GRIFFIN classification system. 40 patients of intertrochanteric fractures fulfilling the inclusion and exclusion criteria, were managed surgically using Trochanteric Femoral Nail – Advanced. The results were analyzed according to age, type of fracture, operative details and functional outcome using KYLE’s criteria. Results: Totally 40 patients with intertrochanteric fractures were operated with TFN-A and were included in the study. The mean age of the patients was around 74.97 years with minimum age being 54 years and the maximum being 92 years. The mean duration of operation was recorded to be 59.69 mins. Complications in this study were seen in 4 patients (10%). Complication was surgical site infection 2 patients (5%), helical blade back out 1 patient (2%), greater trochanteric fracture 1 patient (2%). Conclusion: Trochanteric Femoral nailing-advanced is a versatile implant for all comminuted intertrochanteric fractures, especially in elderly and osteoporotic patients in terms of operating time, surgical exposure, blood loss, and complication rates. Keywords: Intertrochanteric fractures, Trochanteric femoral nail- advanced, (TFN-A), Dynamic hip screw, KYLE’s criteria.