Functional Outcome of Proximal Femoral Nailing for Sub - Trochanteric Fractures

Abstract

Introduction: Sub-trochanteric fractures predominantly occur in individuals over the age of 82 years and account for 7% to 34% of all femoral fractures. These fractures result from low-energy impacts in the elderly and high-energy trauma such as motor vehicle collisions or falls from height in the younger population. The preferred treatment for these fractures involves fixation using an intramedullary device, which is favored over extramedullary devices due to lower risks of non-union and complications associated with the shorter devices.

Aim and Objective: The aim of this study is to analyze the functional outcomes of proximal femoral nailing for sub-trochanteric fractures using the Harris Hip Score in patients treated at Sree Balaji Medical College and Hospital. The objectives include assessing functional scoring, radiological evaluation via X-rays, modes of injury, treatment duration, and associated complications.

Methodology: This prospective, observational study includes 39 patients with sub-trochanteric fractures treated with closed reduction and internal fixation using Proximal Femoral Nailing (PFN). The patients' progress was monitored through follow-up visits at 2 weeks, 6 weeks, and radiological outcomes and functional assessments using the Harris Hip Score.

Results: The study sample comprised 39 patients, with a slight female majority (53.8%). The primary mode of injury was road traffic accidents (51.3%). Radiological evaluations showed effective fracture alignment and progress of union in the majority of cases. The functional outcomes assessed by the Harris Hip Score revealed significant improvements over time, with the majority of patients achieving 'Good' to 'Excellent' scores by the 12-week follow-up.

Conclusion: Proximal femoral nailing proves to be a reliable and effective treatment for sub-trochanteric fractures, as evidenced by favorable radiological alignments and functional outcomes in the patient population studied. The study underscores the efficacy of intramedullary nailing in ensuring quick recovery and return to daily activities, with minimal complications and high rates of union and mobility restoration.