Role of proximal femoral nailing in fracture neck of femur

Abstract

Background: The present study was done (a) to assess the role of proximal femoral nailing in the femoral neck fractures. (b) To assess the effect of early weight bearing after stabilization with proximal femoral nail. (c) To assess the incidence of complications in femoral neck fractures treated by proximal femoral nail. Materials and Methods: The present prospective study was conducted in the department of Orthopedics, of this institute from September 2007 to August 2009, which is a tertiary care center. A total of 22 patients of fracture neck of femur were included in the study. Only patients with basal and transcervical type of fractures with viable femoral head were included in the study. Patients with subcapital type of fracture were excluded from the study. All the patients were followed regularly for a period of two years. These fractures were fixed with proximal femoral nail. The final outcome measurement was done according to Harris hip scoring (HHS) method of functional assessment. Results: Sixty three percent of cases of our study presented with non union and 37% showed osseous union of which three were of basal type and five were of transcervical type. Out of the 22 patients assessed according to Harris hip score only 27.24% cases showed good result whereas 63.56% cases showed poor results. Results based on the anatomical type of fracture showed basal type of fractures with good results of union while 73.68% of the transcervical type of fractures showed poor results. Fair results were seen in 10.25% while only 15.26% of the patients showed good results in transcervical type of fractures. Good results obtained in transcervical type of fracture were the ones associated with subtrochanteric fracture femur. The purely transcervical type of fracture showed fair results in only two patients while the rest showed non union. Conclusions: After conduction of this study on results of the treatment of intracapsular fracture neck of femur by proximal femoral nailing we conclude that (A) proximal femoral nail is useful in basal type of fracture and in those types of transcervical fractures which are associated with ipsilateral subtrochanteric fracture. (B) Proximal femoral nail should be avoided in pure transcervical fracture neck of femur. (C) As it is a small study a further study for transcervical fractures is required.