Outcome Of Proximal Femoral Nail Research Articles

Assessment of the Complication and Radiological Outcome of Proximal Femoral Nailing in Unstable Trochanteric Fractures

Assessment of the Complication and Radiological Outcome of Proximal Femoral Nailing in Unstable Trochanteric Fractures

Assessment of the Functional Outcome of Proximal Femoral Nailing in Unstable Trochanteric Fractures

Assessment of the Functional Outcome of Proximal Femoral Nailing in Unstable Trochanteric Fractures

Functional and radiological outcome of proximal femoral nailing versus dynamic hip screw in unstable intertrochanteric femur fractures

<p class="abstract"><strong>Background:</strong> Intertrochanteric femur fractures account half of the hip fractures in elderly, the other majority being neck of femur fracture. 35-40% of intertrochanteric are unstable (Tronzo’s classification type 3, 4 and 5). The dynamic hip screw (DHS) has achieved widespread acclaim in the last few years and is currently considered to be the standard device for outcome assessment. Though, the DHS has been shown to produce good results, but complications are frequent, particularly in unstable inter-trochanteric fracture. The advantage of Proximal Femur Nailing fixation is that it provides a more biomechanically stable construct by reducing the distance between hip joint and implant. The goal of this study is to assess the clinical and radiographical outcomes of the DHS (load bearing implant) and PFN (load sharing implant) for the treatment of Intertrochanteric hip fractures.</p><p class="abstract"><strong>Methods:</strong> We assessed the same in 52 cases of unstable femur fracture 26 operated with DHS and 26 with PFN and followed up with sequential radiographs for radiological union and sequential interview with Harris hip score calculation for functional outcome assessment.<strong></strong></p><p class="abstract"><strong>Results:</strong> Patients operated for unstable intertrochanteric femur fracture with Proximal femoral nailing had better Harris hip scores (excellent 4, good 14) compared to dynamic hip screw group (Excellent 6, good 5) and earlier weight bearing (At 18 weeks, 100% in PFN compared to 65.5% in DHS). PFN has lesser incidence of postoperative complications (15% in PFN compared to 38% in DHS).</p><strong>Conclusions:</strong>The proximal femoral nail has better functional outcome in terms of Harris hip score and early radiologic union in unstable intertrochanteric fractures of femur. <p> </p>

Study of proximal femoral nail in subtrachanteric femur fracture

Background: Subtrochanteric fractures constitute 10 to 30 percent of all hip fractures. Significant force is required to fracture this bone in adult like motor vehicle accident or fall from significant height while trivial trauma can cause fracture in old people. Various modalities of treatment available for fracture of subtrochanteric fracture femur. The purpose of this study is to assess the outcome of proximal femoral nailing in subtrochanteric fracture femur. Material & Method: 50 cases of subtrochanteric femur fracture underwent surgery with proximal femoral nail carried out at department of orthopaedics, NCH, Surat. The clinical outcome was evaluated by using Harris Hip Score and patient’s satisfaction. Results: In our study majority of the patients i.e. 74% were between the age group of 10-50 years, and from it 78% patients were male, the mean age was 40.5 years and majority of the patients had subtrochanteric fractures due to road traffic accidents. The fracture healing time 16.54 weeks. Conclusion: Closed proximal femoral nail is a safe method and can be performed with minimal complication.

Early functional outcome of proximal femoral nail vs dynamic hip screw in the management of intertrochanteric fractures

Introduction: Intertochanteric fractures are the most frequently operated fracture type and has the highest postoperative fatality rate. Aim of The Study: To assess the early functional outcome of proximal femoral nail v/s dynamic hip screw in the management of intertrochanteric fractures. Materials and Methods: All patients admitted in all the Orthopaedic units of Sri Siddhartha Medical College Hospital and Research Centre, Tumkur with a clinical diagnosis of intertrochanteric fractures were included in this study after obtaining their informed and valid written consent. This study was undertaken from October 2015 to March 2017. Fifty cases of intertrochanteric fractures fulfilling the inclusion and exclusion criteria were divided into proximal femoral nail group and Dynamic hip screw group. Results: Out of 50 patients with intertrochanteric fractures, 25 were treated with proximal femoral nail and 25 were treated with Dynamic hip screw. In Proximal femoral nail group, mean duration of surgery was 82.4+/-14.7 minutes and mean blood loss was 98.4+/-29.1 ml whereas in Dynamic hip screw group, mean duration of surgery was 95.4+/-11.6 minutes and mean blood loss was 204.4+/-61.4 ml. In PFN group, 60% had excellent and 40% had good overall functional outcome. In DHS group, 40% had excellent, 44% had good and 16% had fair overall functional outcome. There were 2 cases of infection and 1 case of implant related complication in the Dynamic hip screw group. Conclusion: The study concluded that both Dynamic Hip Screw and Proximal Femoral Nail remained the implant of choice for the stable intertrochanteric fractures (31-A1). In the more unstable types of fracture (31-A2 and 31-A3), we observed that the Proximal femoral nail was the best choice of implant for fixation since it had better overall functional outcome, less operative time and less blood loss.

Functional Outcome of Proximal Femoral Nail (P.F.N ) in the Management of Intertrochanteric and Subtrochanteric Fractures Femur

Functional Outcome of Proximal Femoral Nail (P.F.N ) in the Management of Intertrochanteric and Subtrochanteric Fractures Femur

Functional Outcome of Proximal Femoral Nail in Unstable Peritrochanteric Fractures of Femur

Functional Outcome of Proximal Femoral Nail in Unstable Peritrochanteric Fractures of Femur

Clinical and functional outcome of proximal femoral nailing in unstable intertrochanteric fractures

Clinical and functional outcome of proximal femoral nailing in unstable intertrochanteric fractures

Retrospective critical analysis of treatment of closed extra capsular proximal Femur fractures with proximal femur nail at rural teaching setup

Background: For extracapsular proximal femur fractures, the treatment options are innumerous, though the implant choice is debatable. In our institute we use proximal femoral nail for the treatment of extracapsular proximal femur fractures. Choosing most suitable implant for such fractures specially in old aged osteoporotic patients till date puts the surgeons in great dilemma. Aim & Objective: To study the clinical results and functional outcome of proximal femoral nail in extracapsular proximal femur fractures routinely used in our institute and to review the available literature. Material & Methods: This study consists of 60 patients who had undergone treatment of proximal femur fractures. Males constituted 70% of the study and 43.6% of the patients were more than 60 years old. Clinical outcome and functional results were evaluated by using Harris Hip scoring system. Results: Mean duration of surgery was 93 min.Post-operative complication rate was 6.7% which was superficial infection. Average time of union is 11.7 weeks. One patient had shortening of 2 cms and 2 patients had shortening of 1 cm. According to the Harris Hip Score we got excellent result in 70% and good result in 20%. Conclusion: Proximal femur fracture is common in elderly due to osteoporosis and mostly occurs due to trivial fall. PFN being a closed procedure, the amount of blood loss and duration of surgery was lesser. PFN is technically easier, with least complications even on follow up. PFN achieved the best clinical results and highest functional scores. Hence we conclude that PFN is the treatment of choice in proximal femur fracture.

Functional outcome of proximal femoral nailing in inter trochanteric fractures of femur: A prospective study

Background: The study was conducted to analyse the functional outcome of Proximal Femoral Nailing in Inter-Trochanteric Fractures of Femur. Methods: Over two years, after obtaining written consent, this prospective study was conducted among 22 patients (age group>18 years) who had Inter-trochanderic fracture treated with Proximal Femoral Nailing. The X-ray of the operated hip was taken whenever it was felt necessary and on 4th week, 8th week, 12th week and at 6th month. Functional outcome measures was done by using Harris Hip Scoring System (Modified) at the end of 6 months. Results: The present series includes, 14 males and 8 females in the age group of 47-82 years with the mean age of 62.09 years. Unstable inter-trochanteric fractures were commonly seen. Excellent results were see in 13 patients. Intraoperative and post-operative complications was seen in 9 patients. Conclusion: From this study, we consider that PFN is an excellent implant for the treatment of trochanteric fractures. With a proper technique, PFN gives excellent clinical results with almost negligible varus collapse even in unstable Inter trochanteric fractures.

Perioperative and Early Postoperative Outcome of Proximal Femoral Nailing for Stable and Unstable Trochanteric Fractures

SummaryThe aim of the study was to analyze perioperative parameters as well as early postoperative period of patients with trochanteric fractures nailing in relation to the fracture stability.The prospective study included 46 patients with trochanteric fractures fixed with the third generation cephalomedullary nail. Two groups were formed - stable fractures (Group 1) and unstable fractures (Group 2). There were 20 patients in Group 1, and 26 in Group 2. All the patients underwent Bioimpianti “basic-nail” fracture fixation. Perioperative and early postoperative parameters were monitored and the groups were compared.The average duration of surgery in both groups was not significantly different. The number of patients needing transfusion as well as the average transfusion volume was similar in both groups. Average Intensive care unit (ICU) stay and hospitalization were longer in Group 1, though not significantly. In both groups, 80% of patients started early rehabilitation according to the protocol.Trochanteric fracture fixation with Bioimpianti “Basic-nail” is a minimally invasive, safe method, giving the similar perioperative and early postoperative outcome regardless of the fracture stability. It enables fast postoperative recovery and reduction of early postoperative complications.

Results of proximal femoral nail in intertrochanteric fractures of the hip with compromised lateral femoral wall: a clinical outcome study

Abstract The ideal method of fixation of intertrochanteric fractures of femur associated with compromised lateral femoral wall is still not clearly defined. The aim of the present study is to evaluate the outcome of proximal femoral nail in unstable intertrochanteric fractures with compromised lateral femoral wall in terms of low rate of complications and re-operation. Twenty-four consecutive patients who had sustained an unstable intertrochanteric fracture according to AO/OTA classification were operated with proximal femoral nail under image intensifier by a single surgeon within a week of sustaining trauma and were followed clinically and radiologically for at least 6 months. Twenty-three patients were available for follow-up after 24 weeks. One patient died due to effects of prolonged immobilization 2 months postoperative as the patient wasn't able to bear weight on affected extremity due to screw cut-out and subsequent varus collapse in immediate postoperative period. There was a mean limb length shortening of 4.29 mm. In 19 of 23 (approx 83%) patients the shortening was less than 10 mm. Four of 24 patients (16%) had developed postoperative complications but none of the patients were re-operated during the subsequent follow-up of 6 months. Proximal femoral nail provides a good outcome in intertrochanteric fractures of the hip with fractured or compromised lateral femoral wall with an acceptable rate of technical difficulties and complications.