A prospective study on surgical management of trochanteric and subtrochanteric femoral fractures with proximal femoral nail in a tertiary care hospital, Andhra Pradesh
Journal Title: Medpulse International Journal of Orthopedics - Year 2019, Vol 10, Issue 1
Abstract
Background: Fractures around the trochanteric region of femur are one of the commonest fractures and the most devastating injuries. Currently, Surgery is the mainstay of treatment for both displaced and undisplaced peri trochanteric fractures. This study consisted of 108 cases of pertrochanteric (intertrochanteric and subtrochanteric) fractures which were fixed with proximal femoral nail and final outcome assessed. Methods: A Prospective study of all cases (108) with peritrochanteric fractures admitted in a tertiary care hospital during a period of 36 months. All the patients were surgically managed with proximal femoral nail and the functional outcome assessed at 6 weeks and 12 weeks post-operatively using Modified HARRIS HIP SCORE system. Results: Maximum age was 65 years and minimum age was 24 years. Mean age was 48 years. Majority 92 (85.2%) of the patients in this study were males and 16 (14.8%) were females. Right side 64 (59.3%) was predominantly involved, with 44 (40.7%) on left side. About 62 (57.4%) met with accident, 26 (24.1%) had self fall, 14 (12.9%) had fall from height and 6 (5.6%) had other causes resulting in fracture femur. While 72 (66.7%) of the patients had no associated injuries, there were 14 (12.9%) cases with head injury, 12 (11.11%) cases with minor abdominal injuries and pelvic injuries, 5 (4.63%) cases each with ipsilateral tibia and Colles fracture. Sub-trochanteric fractures were 85 (78.7%) while 23 (21.3%) were Intertrochanteric fractures. The mean duration of surgery was 80 minutes and mean duration of screening (x-ray exposure) was 103 Seconds. Mean blood loss was 140 ml. At 12 weeks post-operatively, 72 (66.7%) patients had full range of movement at hip joint (0 to 110) and 84 (77.8%) patients had full range of movement at knee joint (0 to 120). The Harris Hip score showed functional outcome as excellent in 15 (13.9%), good in 57 (52.8%), fair in 22 (20.4%) and poor only in 14 (12.9%). Conclusions: The introduction of PFN has broadened the indications for intramedullary fixation of difficult femoral fractures and to include the fractures at the level or below the lesser trochanter. PFN is an effective device in the management of complex femoral fractures.
Authors and Affiliations
Y Siva Sai Kumar Reddy, Rajasekhar Rao G
Keywords
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- EP ID EP539074
- DOI 10.26611/10201011
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