Study of Proximal Femoral Nail in the Management of Peritrochanteric Fractures Femur and Its Functional Outcome

Abstract

Background: Peritrochanteric fractures are devastating injuries that most commonly affect the elderly population and also the young. Conservative methods of treatment results in malunion with shortening and limitation of hip movement as well as complications of prolonged immobilization like bed sores, deep vein thrombosis and respiratory infections. This study is done to analyze the surgical management of Peritrochanteric fractures using Proximal Femoral Nail.

Material and Methods: This is a prospective study of 40 cases of fresh trochanteric and subtrochanteric fractures underwent surgical management using Proximal Femoral Nail.

Results: In our series of 40 cases there were 31 male and 9 female, maximum age of 94 yrs and minimum age of 22 yrs, most of the patients were between 41 to 60 yrs. Mean age of 55.18 yrs. 45% of cases were admitted due to slip and fall and with predominance of right side. Out of 40 cases, 25 were trochanteric and 15 were subtrochanteric. In Trochanteric class 40% were Boyd and Griffin type 2, in Subtrochanteric class 33.3% were Sinsheimer type 3a and 20% were 2b. Mean duration of hospital stay is 20.67 days and mean time of full weight bearing is 16.5 wks. Out of 40 cases 2 cases expired before first follow up time of 6 wks. and 3 cases were lost for follow up. Out of 35 remaining cases 22 were Trochanteric and 13 were Subtrochanteric. Good to excellent results are seen in 90.9% cases of trochanteric fractures and 88.57% cases in subtrochanteric fractures.

Conclusion: PFN is an excellent implant for the treatment of Peritrochanteric fractures. The terms of successful outcome include a good understanding of fracture biomechanics, proper patient selection, good preoperative planning, accurate instrumentation, good image intensifier.