Long proximal femoral nail versus short proximal femoral nail in treatment of unstable intertrochanteric fractures- a prospective randomized comparative study
Journal Title: Indian Journal of Orthopaedics Surgery - Year 2017, Vol 3, Issue 1
Abstract
Background & objectives: In elderly, the Intertrochanteric fractures are one of the most common fractures of the hip out of which more than 50% are unstable. Internal fixation is optimal for it fractures which are very challenging. Evolution of intramedullary devices is a result of dissatisfaction with the extra medullary devices in it unstable fractures our main aim was to compare the effectiveness & drawbacks of short Pfn vs long Pfn in the management of It fractures. Materials and methods: This study was randomised, time bound, hospital based study conducted in a tertiary hospital, between Sept 2013- Sept 2015. The study included 40cases of unstable it fractures of Group A were operated with short PFN which fitted into the inclusion criteria & group B patients were operated with long Pfn, intraoperative parameters post-operative data & events were noted. Radiological assessment for progression & time of union, fracture alignment & implant related complications were analysed. All patients were accessed in immediate post op, 12 days, 1 month, 3months, 6months & at 1 year with Harris hip score. After data collection, data entry was done in excel worksheet. Data analysis was done with help of SPSS software version 23. Result: In our study the most common case of IT fracture was a trauma following a fall seen in 57 cases of the 80 cases studied accounting for 71% of the cause of injury, the mean intraoperative blood loss in the long Pfn group was 344.5 ml & the short PFN group was 133.5 ml, P value equals 0.0001 this difference is considered statistically significant. The quality of reduction in the short PFN group was significantly lesser than the long PFN group. The post operative complication in the short PFN group was significantly lesser than the long PFN group. The number of cases with limb shortening were more in the short PFN group than the patients in whom long PFN was used. The mean time of union in the short PFN group was 10.05 weeks and the long PFN group was 21.10 weeks. The two- tailed P value equals 0.0217 by conventional criteria, this difference is considered to be statistically significant. The mean lower extremity functionally scale. In the short PFN group was 63.95 & the long PFN group was 67.50. The two tailed P value equals 0.0114 statistically significant. Interpretation & conclusion: Short Proximal Femoral Nail provides good fixation for unstable IT fractures, if proper preoperative planning , good reduction & surgical technique are followed , leading to high rate of bone union & soft tissue damage especially for Asian patients with relatively small femora.
Authors and Affiliations
Mahesh Kumar NB, Ullas Mahesh, Santosh Kumar
Keywords
Related Articles
- EP ID EP292881
- DOI 10.18231/2395-1362.2017.0010
- Views 102
- Downloads 0
Functional outcome analysis in floating knee injury
Introduction The term floating knee is defined as simultaneous ipsilateral fracture of femur and tibia that disconnect the knee from the rest of the limb Due to the complexity of injury and associated complications such...
Comparative study between InterTAN and Trochanteric femoral nailing (TFN) in Inter-trochanteric fractures: A prospective study of functional and radiological outcomes
Introduction: A prospective study was done in the Department of Orthopedics in Dr. D.Y. Patil Hospital, Navi Mumbai from January 2015 to March 2017 to Compare between Inter-Tan and trochanteric femoral nailing in Inter-t...
Study of clinical outcome following arthroscopic anterior Crucitate ligament reconstruction using autologous quadruple hamstrings graft
Introduction The Anterior Cruciate ligament ACL is the primary stabilizer of the knee and prevents the knee against anterior translation Arthroscopic reconstruction of torn ACL has become the gold standard in treating AC...
Transpatellar “central†portal for an arthroscopic hamstring tendon graft reconstruction of the Anterior cruciate ligament
Purpose to evaluate the efficacy of central poartal in the reconstruction of AM and PL ACL bundle reconstruction as a viewing portal. Methods: This study was conducted on series of 55 patients operated for ACL ruptures,...
A rare case of para-articular chondroma of the hip joint in an adolescent
Extraskeletal chondromas are unusual benign skeletal tumors which do not arise from the bone or perisoteum. They are predisposed to occur in adults usually around the knee joint. We report a rare form of Extraskeletal ch...