Assessment of Outcome and Complications of Proximal Femoral Nail in The Management of Intertrochanteric Fractures
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 5
Abstract
Introduction: Years ago, intertrochantric fractures often used to be a terminal event in the life of feeble and fragile patients. The basic problem was not of union, but of complications arising due to immobilisation in bed till fracture heals. Inspite of improvement and modifications in conservative line of treatment, the ideal anatomical and functional result could not be achieved; prolonged immobilisation in bed was another important threat to life of elderly patients. So here is an effort to study the results of surgical management of intertrochanteric fractures with proximal femoral nails (P.F.N). Materials and Methods: The present study was conducted in department of orthopaedics, among 30 adult cases of intertrochanteric fractures. Proximal Femoral Nail (P.F.N) Implant System with a standard length P.F.N. of 240 mm with distal diameter of 10-12mm and the neck –shaft angle of 1350 and with 60 medio lateral angulation was used. The final position of the nail was checked in the C-arm in both views, AP and Lateral and the wound was closed in layer. All patients were followed up, at every visit; patient was evaluated clinically and radiologically regarding hip and knee function, fracture union, implant failure, infection, etc. Results: The delayed complications in our study includes hip joint stiffness in 3 (10%) cases, knee joint stiffness in 1(3%) case, varus angulation in 1(3%) case, Z- effect in 1(3%) case and shortening >1cm in 1(3%) cases. At the end of our follow up, results were evaluated by KYLE’S criteria and were excellent in 50% (15 patients), good in 26% (8 patients), fair in 16% (5 patients) and poor in 6% (2 patients). Conclusion: Proximal femoral nail (P.F.N.) can be considered the most judicious, effective and rational method of treating intertrochanteric femoral fractures specially the unstable and reverse oblique type of intertrochanteric femoral fractures. But it is technically demanding so require higher surgical skill and expertise, proper fracture table, good instrumentation and image intensifier control. It has a steep learning curve. Thus, we can conclude that Proximal Femoral Nail (P.F.N.) fixation after proper training and technique is an effective and safe implant option for treatment of intertrochanteric fractures specially in unstable and reverse oblique type of intertrochanteric fractures.
Authors and Affiliations
Atul Pandey, GBS Kohli
Keywords
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- EP ID EP537006
- DOI 10.21276/ijmrp.2018.4.5.040
- Views 86
- Downloads 0
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