EFFICACY OF PROXIMAL FEMORAL NAIL IN PROXIMAL FEMORAL FRACTURES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 81
Abstract
BACKGROUND Fractures of the subtrochanteric region of femur can be difficult to treat. This anatomic region experiences the highest tensile and compressive stresses in the human skeleton. The proximal fragment is often quite short, offering limited opportunity for internal fixation, which must withstand these substantial forces. In subtrochanteric fracture the proximal fragment is flexed, abducted and externally rotated due to the iliopsoas, abductor muscles and short external rotators muscle pull. Hence, it is useful to perform an open reduction of the fracture fragments and then stabilise the proximal fragment to restore anatomical position prior to nail insertion. MATERIALS AND METHODS The observational study consists of 20 adult patients with proximal femoral fractures of femur who were treated with PFN at BIMS, Belgaum, between Jan 2014 and March 2017. The fractures were classified according to Russell and Taylor classification. Twenty cases were followed at regular intervals. This study was conducted with due emphasis for clinical observation and analysis of results after surgical management of proximal femoral fractures of femur with proximal femoral nail. RESULTS In our study of subtrochanteric fractures treated with PFN, we encountered intraoperative complications like iatrogenic fracture of lateral cortex in 2 cases (10%) due to selection of wrong entry point, failure to put derotation screw in 2 cases (10%) and guidewire breakage in 1 case (5%). Delayed complications like hip joint stiffness in 3 cases (15%), knee joint stiffness in 1 case (5%) and shortening of more than 1 cm in 1 case (5%) and delayed union in 2 cases (10%). CONCLUSION Open reduction offer advantage in preventing malalignment of subtrochanteric fractures as compared to closed reduction. From our study, we conclude that PFN is a reliable implant for subtrochanteric fractures leading to high rate of bone union restoring the anatomical alignment and reduced chance of implant failure or deformities.
Authors and Affiliations
Prakash Wali, Santosh Mared
Keywords
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- EP ID EP275348
- DOI 10.14260/jemds/2017/1237
- Views 93
- Downloads 0
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