Outcome of Treatment of unstable intertrochanteric fractures with proximal femoral nail: A retrospective study

Abstract

Background: Intertrochanteric fractures occur frequently in older age groups due to osteoporosis. The main aim of surgery is stable fixation that allows to mobilize the patient early. The treatment of choice for trochanteric fracture remains controversial. Treatment of unstable intertrochanteric fracture is still challenging and are being treated successfully with proximal femoral nail.The purpose of this study is to evaluate the functional and radiological outcome and complications of proximal femoral nail in the treatment of unstable intertrochanteric fractures. Method: A retrospective study on 100 patients was conducted with unstable intertrochantric fractures treated with Proximal femoral nail .Fracture were classified according to the AO classification system. The fixation used a proximal femoral nail (9-11mm in diameter), a lag screw (85-105 mm in length) and a antirotation pin (10-15 mm shorter than the lag screw). Clinical evaluation was done using Harris hip score and radiologically at 6 weeks, 12 weeks, 6 months, 9 months and thereafter every 6 months. Results: Most of the patients were between 40-60 years (Mean 50.35 years). Most commonly the mode of injury, wrist involvement & fracture type were RTA (50.3%), Right side (60.3%) and AO type C1 . Mean pain score & Function score (PRWE) were less among patients where radiological parameters were restored. Conclusion: We have suggested that proximal femoral nail offers advantages for the fixation of unstable intertrochanteric fractures with less operative time. It can be easily inserted and provide stable fixation with less complications.