Role of Proximal Femoral Nail in the Treatment of Unstable Intertrochanteric Fractures

Asad Khan Ghilzai¹, Syed Kamran Ali Shah*², Muhammad Ayub Khan³, Muhammad Arsalan Ghazi² and Muhammad Kazim Rahim Najjad¹

Received: December 29, 2017;   Published: January 09, 2018

DOI: 10.26717/BJSTR.2018.02.000645

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Abstract

Objective: To evaluate the functional outcome of unstable Intertrochanteric fractures treated with proximal femoral nail while using Harris hip score.

Methods: This is a prospective observational study conducted at Orthopaedic Surgery Department. Total 91 patients of either gender with age between 18 to 70 years had closed AO type 31A2 and 31A3 unstable Intertorchanteric fractures of proximal femur and for ease labelled as type I and type II subsequently. All patients were operated with proximal Femoral Nail, using a standard prescribed surgical technique. After 3 months of surgery, patient was called for follow up and asked to answer the Harris hip score questionnaire. Effect modifiers were controlled by stratification using chi square test and p-value ≤0.05 was considered as significant.

Result: Total 91 patients were enrolled, 59 male and 32 were female. The mean age was 47.66±13.40 years, with range of 50(20-70) years. 32(35.2%) patients were aged ≤45 years and 59(64.8%) patients were aged >45 years. 46.2% patients had type-I fracture and 53.8% had type-II fracture. Excellent outcome observed in 28.6% patients, good in 45.1%, fair outcome in 16.5% and only 9.9% expressed poor outcome among 91 patients. No significant association of functional outcome observed with respect to gender (p=0.289), age (p=0.127), type of fracture (p=513), and mode of admission (p=0.662).

Conclusion: Proximal Femoral Nailing is one of safe and better ways of treating unstable intertrochanteric fractures to achieve significantly better outcomes with early rehabilitation as its advantages of being inserted through small exposure, preservation of hematoma and less blood loss. Hence, we observed in our study the Proximal Femoral Nail may be the better fixation implant for unstable intertrochanteric fractures.

Keywords: Unstable Intertrochanteric Fractures; Proximal Femoral Nail; Harris Hip Score

Abbreviations: IT: Intertrochanteric; PFN: Proximal Femoral Nail; PFNA: Proximal Femoral Nail Anti rotation

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