Study of the Outcome of Inter Trochanteric Fractures of the Femur Treated with Proximal Femoral Nailing
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 2
Abstract
Abstract: The incidence of fractures in the trochanteric area has risen with the increasing numbers of elderly persons with osteoporosis. The treatment of unstable trochanteric femoral fractures is still challenging, and the proximal femoral nails are becoming more commonly used. Apart from the nail design, the surgical technique is also important for the successful outcome. The aim of the present study was to evaluate and analyze the outcome of the surgical management of Intertrochanteric fractures of the femur by using Proximal Femoral Nail. The present study was done in Department of Orthopedics, RIMS ADILABAD. Patients with the diagnosis of Intertrochanteric fracture from Aug 2013 to Feb 2016. The total numbers of cases operated in 2.5 years were 187 and the patients were informed about the study in all respects and informed consent was obtained from each patient. Patients admitted with Intertrochanteric fracture were examined and investigated with X-ray pelvis with both hips AP and Lateral view (whenever possible). All fractures were treated using a proximal femoral nail. There were 80 females and 107 males in the study. Domestic fall and road traffic accident were the modes of injury in all the patients. The fracture was reduced anatomically by closed means in 165 patients and 22 were reduced by limited open reduction during surgery. Results of treatment according to Kyle's Criteria were Excellent in 117 cases, good in 55 cases, fair result in 10 cases and poor in 5 cases. There were 3 cases of implant failure. In all the 3 cases the ‘Z'- an effect of implant failure was seen. Early weight bearing, Severe osteoporosis, severe posteromedial communication were the causes of this failure. From the present study we conclude that PFN is an excellent implant for the treatment of Intertrochanteric fractures. The successful outcome also depends upon proper patient selection, the good understanding of fracture biomechanics, good preoperative planning, accurate instrumentation, good image intensifier and exactly performed osteosynthesis.
Authors and Affiliations
Deepak Pushkar
Keywords
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