Online ISSN: 2515-8260

Keywords : intertrochanteric fractures

Functional outcome in intertrochanteric fractures treated with proximal femoral nail

Dr. Yogesh Kadam, Dr. Vinay, Dr. Shivanand Doddamani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1131-1135

The most widespread internal fixation device used today is the fixed angle extramedullary device, such as a 95-degree lag screw and side plate or blade plate. This implant includes a large lag screw positioned in the center of the femoral neck and head and a side plate alongside the lateral femur. The screw-plate interface angle is changeable and depends on the anatomy of the patient and the fracture. A total of 30 patients who were admitted with intertrochanteric fractures that fitted into the inclusion criteria and managed surgically with proximal femoral nail were included in the study. In our series, Boyd and Griffin type II and type III contributed eighteen and six cases in each group, making to 60% and 20% followed by type IV contributing 6 cases making 20%. We performed closed procedure in 26 cases (87%) and open nailing in 4 cases (13%). The average duration of radiation exposure was 120 seconds, average duration of surgery was 95 minutes and average blood loss was 140 ml with 23% intraoperative complications

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.