2018, Vol. 2 Issue 4, Part C
Introduction: Subtrochanteric fractures of the femur account for 7-44% of all proximal femur fractures. Conservative treatment in these fractures has no role. Two principal options exist for unstable fractures. Either angular locking plate or a sliding neck screw via a closed technique. Proximal femoral nail (PFN) is a newer implant used for internal fixation of peritrochanteric fractures.
Objectives: To compare the Radiological and Functional Outcome of Subtrochanteric Fractures treated with proximal femoral nail (PFN) and locking compression plate (LCP) and to evaluate the results.
Methodology: The present study was a prospective randomized study on patients with subtrochanteric fractures admitted in department of Orthopaedics, S.M.S. Hospital, Jaipur during May 2012 to Dec 2013. Patients were allotted in PFN (Group 1) and LCP(Group 2) group on random number basis (Chit box method) with 26 patients in each group.
Results: The mean duration of surgery in group 1was 53.85 min and in group 2 was 70.77 min. There was increase requirement of blood transfusion in group 2(statistically significant). Mean full weight bearing time was 11.68 weeks in group 1 and 12.40 weeks in group 2(not statistically significant). Mean time for union in group 1 was 13.88 + 1.64 weeks while in group 2 14.16+ 1.99 weeks (not statistically significant). There was increased infection rate in group 2(11.53%) as compare to group 1(3.84%). There was 7.69% varus malunion in group 2 compare to 3.84% varus in group 1. There was 3.84% delayed union in group 1 compare to 7.69% in group2. Limb length discrepancy of 1 cm was present in 3.84% in PFN while 7.69% in LCP group. Complications in both group were comparable. Functional outcome was evaluated in terms of modified Harris hip score. Average score in group 1 was 91.36 and 86.32 in group 2 (statistically significant). Patients in group 2 had experienced more pain around hip.
Conclusion: To conclude PFN to be a safe, reliable and successful implant for subtrochanteric femoral fractures. PFN combines the intrinsic advantage by taking less operative time, high rate of union, minimal soft tissue damage, less infection rate and early postoperative rehabilitation.