2020, Vol. 4 Issue 4, Part A
Abstract: Background and Aim:
Subtrochanteric fractures typically occur in the proximal femur between inferior aspect of lesser trochanter and distance of about 5cms distally or the centre of isthmus of femoral shaft. These fractures of femur are one of the most difficult fractures to treat. The primary aim of the study was to assess the results of proximal femoral nail of subtrochanteric fractures, to assess the functional outcome, radiological union and compare the same with other studies which have used a different modality of treatment.
Material and Methods: This was a retrospective study done on 50 patients with subtrochanteric fractures classified by Sienshiemer classification and operated by proximal femoral nail implant. Clinical evaluation was done by Harris hip score. The data was collected by interviews, follow up at intervals of 1, 2, 4 and 6 months, clinical examination and analyzing case papers.
Results: Most common cause of injury in our study was fall down closely followed by road traffic accident. Associated injury Overall, 24% of the patients had associated injuries. 17% of patients had associated injury in form of fracture shaft femur, distal end radius and calcaneum fractures etc. Complications Infection occurred in 3 cases, non-union in 3 cases, Backout of screws in 3 cases and breakage of screws in 2 cases.
Conclusion: The study results conclude that PFN (intramedullary implant) has proved to be better implant than extramedullary implant; PFN is a closed method, thus preserves the fracture hematoma yields early healing and less mean radiological union time in comparison to extramedullary implants; it is a quick procedure in the hands of experienced surgeon who has overcome the ‘learning curve’ with small incision significant less amount of blood loss and minimal preoperative complications.