A Prospective Study of the Functional Outcome of Intertrochanteric Femoral Fracture Managed with Short Proximal Femoral Nail
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Date
2020-02
Journal Title
Journal ISSN
Volume Title
Publisher
International Society for Contemporary Medical Research
Abstract
Introduction: Fractures through the intertrochanteric lineof the upper end of the femur, and peritrochanteric fractures,unite readily no matter what treatment is used because thebroad fractured surfaces are richly supplied with blood andthere is seldom wide displacement. But at the same time,unless suitable precautions are taken, the fracture may unitein a position of coxavara with shortening of the limb andlimitation of hip movements. Hence we conducted a studyin our set up to know the functional result of short proximalfemoral nail (PFN) in treatment of these fractures.Material and Methods: We included all intertrochantericfracture of femur in skeletally mature patient who are fit forsurgery in our study. Fifty patients treated with short PFNwere included in the study.Results: Majority of the patient in our study were between61-80 years with a mean age of 74.46 ± 12.04 years. About 52percent of the patients were female and 48 percent male. Fallat home was the most common mode of injury. Right hip wasinvolved in 48% of the patient and left hip was 52%. The shortPFN required shorter incisions, less blood loss and operativetimes. Average time for operation was 42.30±10.01. Postoperative complications included revision surgery 2 (4.0%)patients, superficial infection in 2 (4.0%), Z effect in 1 (2.0%)patient, inadequate reduction in 1 (2.0%) patient, difficultyin distal locking in 1 (2.0%) patient and varus in 1 (2.0%)patient. The average harris hip score came out to be 87.37at 24 weeks and 90% of the patients belonged to the ‘good’group and 6% of the patients belonged to the ‘excellent’group intertrochanteric fractures, treated with short PFN, hadsignificantly better outcomes with all patients having goodresults in 24 weeks which is very short time. Conclusion:Intra operative technical difficulties associated with short PFNcan be reduced by thorough knowledge and understanding ofboth the anatomy and implant. By using some technical tipsdifficult closed reduction can be done and internal fixationwith PFN can be attempted.
Description
Keywords
Femur, Intertrochanteric Fracture, Proximal Femoral Nail, Intramedullary Device, Harris Hip Score
Citation
Purohit Arnik, Choudhary Preetesh, Phatak Shreesh. A Prospective Study of the Functional Outcome of Intertrochanteric Femoral Fracture Managed with Short Proximal Femoral Nail. International Journal of Contemporary Medical Research . 2020 Feb; 7(2): b9-b14