Study on Proximal Femoral Nail in the Treatment Intertrochanteric and Subtrochanteric Fractures, an Observational Study
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 4, Pages 1526-1532
AbstractIntroduction: Intertrochanteric and subtrochanteric fractures are devastating injuries that most commonly affect the elderly, but it is not uncommon in younger age group, have a tremendous impact on both the health care system and society in general. Peri trochanteric fractures mainly comprise of fractures of trochanter and subtrochanteric region. There are various forms of internal fixation devices used for Trochanteric Fractures, of them the most used device is the Dynamic Hip Screw with Side Plate assemblies. This is a collapsible fixation device, which permits the proximal fragment to collapse or settle on the fixation device, seeking its own position of stability.
Objectives: 1) To assess the stable fixation and early mobilization of patients with Intertrochanteric and subtrochanteric fractures. 2) To analyze the anatomical and functional outcome of treatment of Intertrochanteric and subtrochanteric fracturesusing Proximal Femoral Nail.
Methodology: The present study consists of 40 adult patients of intertrochanteric and subtrochanteric fractures, who are treated with Proximal Femoral nail in Mahatma Gandhi Memorial Hospital, attached to Kakatiya Medical College, Warangal, Telangana state between November 2012 and June 2014.
Results: Mean duration of screening was 90 seconds, mean duration of operation 90 minutes and Mean blood loss 130 milli liters. Intraoperative complications were,15% Failure to get anatomical reduction, 15% Failure to put derotation screw,15% Varus angulation and 10% Failure of distal locking. Fracture of lateral cortex, Breakage of guide wire and Breakage of drill bit observed 5% of operations. In our study the average duration of hospital stay was 19.33 days. The mean time for full weight bearing was 12.6 weeks. All patients enjoyed good range of hip and knee range of motion except one who had septic arthritis knee. Post-operative mobility was aided in immediate post-operative period but later all patients were ambulatory independently with or without walking aid after 6 weeks.
Conclusion: The terms of successful outcome include a good understanding of fracture biomechanics, proper patient selection, good preoperative planning, accurate instrumentation, good image intensifier and exactly performed osteosynthesis.
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