Online ISSN: 2515-8260

Keywords : Intertrochanteric Fractures


Short Proximal Femoral Nail A2 Vs Long Proximal Femoral Nail A2 For The Management of Intertrochanteric Fractures in Elderly

Dr.Santosh Kumar Sahu; Dr.Abhishek Pandey

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 6, Pages 1144-1149

Background: Elderly hip fractures are a very frequent orthopaedic issue.Although varioustreatment methods have been suggested in past for the management of intertrochanteric fractures in geriatric population,itstill emainscontroversial as regards the treatment of choice to manage these fractures . The current study demonstrates the efficacy of proximal femur-intramedullary nail antirotation (PFNA2) of Asia inmanaging fractures of inertrochanteric.Our study will be based upon the comparision of effectiveness and shortcomings we encounter while using short proximal femoral nailA2vs long femoral nailA2 for managing fractures of intertrochanteric.Methods& Materials:The above research has beendone at IMS and SUM hospital between November 2016 to November 2019. 87 individuals having fracturesare chosen.Group-a had 45 patients treated with short PFNA2,group-bhad 42 patients,whowere treated with long PFNA2.All fractures were classified as per Orthopedic Trauma Association(OTA) AS 31A1,31A2,31A3.All the patients were evaluated on immediate post-operatively, 1st, 3rd, 6th and 12th month using Harris hip score.
Results:Current study shows that the frequently occurring fracture modes is trivial traumafollowed by fall, which was observed within 58 out of 88 cases,which comes out to be 65.5% of reason behind the fracture. Average operative loss of blood was 226.5ml withinPFNA2group,whereas it was 124.5ml in the short PFNA2group.The factor regarding union was better in the short PFNA2(10.2weeks)than the long PFNA2 group(20.1weeks).However,limb shortening was found to be more in the short PFNA2 as against the long PFNA2.Anterior femoral canal impingement was found to be more with long PFNA2(5 cases)compared to short PFNA2(1case).
Conclusion:Observing the above findings for method of managing trochanteric fractures ,short PFNA2 emerges as a better choice vs long PFNA2,if proper preop planning is used leading to less soft tissue damage and as a result high rate of union,especially in the Asian population who have a small femur.

A Prospective Study of Clinico-radiological Outcome Assessment in Proximal Femoral Fractures treated with Proximal Femoral Nail

Dr Rameez R Bukhari; Dr Ratnakar Ambade; Dr. Prachi Palsodkar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 1861-1867

Introduction: Fractures of the proximal femur including the intertrochanteric and subtrochanteric region which are commonly encountered in Orthopaedics especially in elderly population having porotic and weak bones. In elderly these occur even with minimal or trivial trauma ,whereas in the younger population these result from high velocity trauma. These injuries are in association with a high incidence of mortality and morbidity. These injuries were treated conservatively prior to the early 1970’s and are now treated totally surgically now. The goal of any treatment in fracture is stable fixation, 
ultimately leading to early mobilization and decreased incidence of morbidity and mortality. Many surgical interventions like Gamma Nail, Jewet Nail, Condylar plates had been tried but the outcomes were not very satisfactory, so we conducted a study to determine the clinical and radiological outcome in treating such fractures with PFN.
Aim of the Study: Clinical And Radiological Outcome Analysis of Proximal Fractures of femur when Treated with Proximal Femoral Nail
Materials and Methods: A prospective study done in the Department of Orthopaedics at Jawaharlal Nehru Medical College And Acharya Vinoba Bhave Rural Hospital , Datta Meghe Institute Of Medical Sciences ,Sawangi. Patients with Proximal femoral fractures managed with PFN and subsequent follow up at regular intervals for a duration of 1 year.
ExpectedResults:The functional assessment shall be done on the basis of Modified Harris Hip scoring, and at subsequent followed up radiologically with serial X-rays.
These patients with proximal femoral fractures that include intertrochanteric and subtrochanteric fractures, treated with Proximal Femoral Nail are expected to have a shorter incision and subsequently less intraoperative blood loss than the previously used implants. Patients are expected to bear weight earlier.