LONG PFN NAILING IN COMMINUTED HIGH SUBTROCHANTERIC FRACTURES OF FEMUR IN ELDERLY PATIENTS- A HOSPITAL BASED CLINICAL TRIAL
Abstract
Background:The various types of adult proximal femoral fractures require different treatment strategies that depend on a variety of considerations, including the location, morphologic features, injury mechanism, and stability of the fracture, as well as the patient’s age and baseline functional status. Subtrochanteric fractures are femoral fractures occurs below the lesser trochanter to 5 cm distally in the shaft of femur.
Objectives:To study the functional outcome of proximal femoral fractures treated with Long Proximal femoral nail in elderly patients.
Methods: This was a prospective clinical trial of femoral Subtrochanteric fracture performed on 300 patients of 40-90 year of age range in three years. All the patients weresurgically treated with long proximal femoral nail. Regular follow-up of all cases was done at 2 weeks, 4 weeks and 2 months. At each follow-up, patients were evaluated clinically using the Harris hip score and radiologically with appropriate X-rays.
Results: In our study of 300 cases, Male preponderance and left sided hip fracture was found to be mostly predominant. In our study hospital stay ranges from 1-20 days with a mean average of 10.2 days. Harris hip score was found to be excellent in 81 (27%); good in135 (45%); fair in 50 (16.67%) and poor in 16 (5.4%) patients. All the results showed statistically significant. Five deaths were reported which were not related to the surgical repair.
Conclusion: From our study, we conclude that long proximal femoral nail is a reliable implant for subtrochanteric fractures leading to big rate of bone union and minimal soft tissue damage. Intramedullary fixation has biological and biomechanical advantages but the operation is technically demanding. Gradual learning and great patienceare needed in order to make this method truly minimally invasive.
Keywords:Long Proximal Femoral Nail (PFN), Subtrochanteric Fractures, Boyd and Griffin Classification, Harris hip score.
