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National Journal of Clinical Orthopaedics
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2020, Vol. 4 Issue 3, Part A
Results of proximal femoral nail in intertrochanteric fracture of femur
Author(s): Dr. Dhrumil Dave, Dr. Janak Mistry, Dr. Krishna Kumar and Dr. Kaushal Upadhyay
Abstract: Introduction: Intertrochanteric Femur fractures comprise approximately half of all hip fracture caused by low energy mechanism. These hip fractures occur in characteristic population with risk factors including increasing age, female gender, osteoporosis, a history of fall and gait abnormality. In spite of great advances made in the field of trauma in last 50 years management of this fracture has always remained subject of debate. There are several internal fixation options for managing these fractures that generally fall into two categories: some form of intramedullary fixation or some form of plating. Proximal Femoral Nailing is load bearing device with rotational stability and also short lever arm in addition to indirect fracture reduction.
Materials & Methods: In this age group, we have done a prospective study in 70 patients of proximal femur fractures of femur operated with proximal femoral nailing at our institute with follow up of 5 – 24 months. All patients between above 31 years of age with proximal femur fractures of femur admitted in tertiary center in government setup - meeting the inclusion and the exclusion criteria during the study period were the subjects for the study. Patient were regularly followed up radiologically. Final outcome is measured with Harris Hip Score.
Results: In the present study, 70 cases of intertrochanteric fractures treated operatively with proximal femoral nail (PFN), and the results were analyzed. In this series, low velocity injury (Domestic fall) was the cause of fracture in the majority (70%), especially in the elderly female patients. Boyd & Griffin type 2 was the commonest type (42%) following fall while walking, etc. The operations were completed within 2 hours in 98% of the patients. For PFN minimum duration was 40 minutes and maximum duration was 150 minutes and mean duration was 80 minutes. On final follow up one patient had iatrogenic basicervical fracture, one patient had outward migration of screw, two patient had backout of derotation screw, 10 patient had varus collapse, five patient had abductor weakness on followup. On 6 month follow up thirty patient had separated lesser trochanter with union of fracture but there was no limitation of movement & any residual deformity. The functional result according to Harris Hip Score was found to be excellent in 51.42%, good in 31.42%, fair in 10% and poor in 7.14% of patients.
Conclusion: Intertrochanteric fractures commonly occur in elderly persons, usually following minor trauma whereas in young patients a major trauma is needed to cause this fracture. Proximal femoral nail offer less invasive option for fixation of intertrochanteric hip fractures. Unstable fractures can be fixed faster and with lesser soft tissue dissection. On basis of our study we have concluded that PFN should always be considered for management of intertrochanteric fractures in young as well as elderly patients who have multiple pre-existing illness.
Pages: 46-52  |  1076 Views  300 Downloads

National Journal of Clinical Orthopaedics
How to cite this article:
Dr. Dhrumil Dave, Dr. Janak Mistry, Dr. Krishna Kumar, Dr. Kaushal Upadhyay. Results of proximal femoral nail in intertrochanteric fracture of femur. Nat J Clin Orthop 2020;4(3):46-52 DOI: https://doi.org/10.33545/orthor.2020.v4.i3a.236
National Journal of Clinical Orthopaedics
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