Proximal femoral nailing in the management of subtrochanteric fractures of femur in adults

Abstract

Introduction: The proximal femoral nail (PFN) used as an intramedullary device for the treatment of fractures. Objectives: Study was taken to analyse the union of the subtrochanteric fracture, internally fixed with PFN. Materials and Methods: Study was conducted in the department of orthopaedics, GSL Medical College. Individuals with acute subtrochanteric femur fractures >18 years were included in the study. The patient was positioned supine on the fracture table under spinal or epidural or general anesthesia as the condition of the patient permitted. Pre-operatively one dose of antibiotic was also administered. The fracture was reduced by longitudinal traction on fracture table and the limb was placed in neutral or slight adduction to facilitate nail insertion through the greater trochanter ; P Results: At the end of five months, all except three patients could mobilise independently; statistically there was significant difference (P excellent, 18 patients were good and 4 patients had fair outcome. Conclusion: Minimal exposure, better stability and early mobilization are the advantages with PFN. Fractures united in all cases and postoperative functional outcome was satisfactory. PFN could be a preferred implant of choice in treating subtrochanteric fractures especially in elderly. Keywords: Fracture, Femur, Operative, Subtrochanteric.