Proximal Femoral Nail in Reverse Trochanteric Femoral Fractures: An Analysis of 53 Cases at One Year Follow-Up

Yogesh Salphale,Alankar Ramteke,Wasudeo Mahadeo Gadegone,Raviraj Shinde,Prakash Lalwani,Nirbhay Karandikar

doi:10.4236/ss.2016.77043

Abstract

Treatment of reverse oblique trochanteric femoral fractures poses a lot of challenges. There have been proponents of intramedullary devices as well as extramedullary devices. We present the results of proximal femoral nailing surgery performed for reverse obliquity intertrochanteric fractures using two proximal lag screws and a nail of 250 mm. There is prospective study of fifty three patients with AO/OTA 31 A-A3 fractures being treated by proximal femoral nailing in our institute after seeking approval from the Hospital ethics board. The quality of the reduction, the operative time, complications and the functional status of the patients were the parameters on which the results were evaluated. The mean Harris hip score was 76.66 (range 70 - 93) and the mean Barthel activity score was 16.21 (range 12 - 20). The average surgical time was 50 minutes and the mean consolidation time was 11.5 weeks. Intramedullary nailing with proximal femoral nails seems to be a good option in the treatment of reverse obliquity intertrochanteric fractures as against the various existing options available for the management.

Highlights

The incidence of fractures in the proximal femoral area has risen with the increasing numbers of elderly persons
We present the results of proximal femoral nailing surgery performed for reverse obliquity intertrochanteric fractures using two lag screws, and include evaluation of the quality of the reduction, operative time, complications and functional status of the patients
From Feb 2005 to Feb 2014, 53 patients with AO/OTA 31 A-A3 fractures were treated by proximal femoral nailing in our trauma centre

Summary

Introduction

The incidence of fractures in the proximal femoral area has risen with the increasing numbers of elderly personsHow to cite this paper: Salphale, Y., Gadegone, W.M., Ramteke, A., Karandikar, N., Shinde, R. and Lalwani, P. (2016) Proximal Femoral Nail in Reverse Trochanteric Femoral Fractures: An Analysis of 53 Cases at One Year Follow-Up. (2016) Proximal Femoral Nail in Reverse Trochanteric Femoral Fractures: An Analysis of 53 Cases at One Year Follow-Up. Surgical Science, 7, 300-308. This typical bimodal pattern of injuries presents with an array of clinico radiological pictures. Fractures about the trochanteric area are classified according to the Orthopaedic Trauma Association classification system as AO/OTA 31-A, which delineates them as extracapsular fractures of the hip. These fractures are subdivided into groups A1, A2 and A3 based on the radiological classifications.

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Results

Conclusion