The role of proximal femoral nail in the management of inter trochanteric femur fracture and its functional outcome: A prospective study from Southern India
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 8, Pages 1996-2002
Abstract
The most common hip fracture is an intertrochanteric femur fracture, which is more likely in older population with osteoporotic bones and with a male preponderance. The proximal femoral nail (PFN), developed by the AO/ASIF group, has demonstrated its stability as an implant in femoral fractures with peritrochanteric, intertrochanteric, or subtrochanteric fractures [6]. So, the current study was conducted with the aim of assessing the role of proximal femoral nail in the management of intertrochanteric femur fracture and its functional outcome.Methods: The Department of Orthopaedics at Sree Uthradam Thirunal Academy of Medical Sciences Hospital, Thiruvananthapuram, Kerala, South India, undertook this current prospective cohort study from January 2021 to June 2022. On the basis of predefined inclusion and exclusion criteria, a total of 48 patients were included in present study. A pretested questionnaire was used to record patient details such as age, gender, type of fracture, time period of union of fracture in open and closed reduction, complications and functional outcome. The Boyd and Griffin classification was used to classify intertrochanteric fractures. Patients were followed up at 3, 6, and 12 weeks and finally at 6 months postoperatively for functional outcome as assessed by Kyle’s criteria. The statistical tests were considered if P value was <0.05.
Results: In our study, an aggregate of 48 patients were enrolled, male patients predominated (n=32) the study and there were 16 female patients. The mean age of patients was 48.57±8.13 years. In our study, Type I fracture were 4.1%, Type II fracture were 66.7%, Type III fracture were 6.3% and Type IV fracture were 22.9%. The difference in the time taken for union for fracture approached via closed and open reduction technique was not significant (p>0.05). In our study, the postoperative complications were screw failure (12.5%), and varus malalignment (4.2%). The functional outcome as excellent was enhanced as it was 20.8% at 3 months and 33.3% at 6 months.
Conclusion: Before being used by an orthopaedic surgeon, all latest implants and instrumentations must undergo a rigorous assessment. In our study, the proximal femoral nail, which was made use of to treat intertrochanteric fracture, achieved good results in terms of both functional and radiographic performance.
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