Functional and radiological outcome of long proximal femoral nail in subtrochanteric femur fracture

  • Singh V Study performed at Department of Orthopaedics, R. D. Gardi Medical College & C. R. G. Hospital & Associated Charitable Hospital, Ujjain (M.P.)
  • Rathore S S Study performed at Department of Orthopaedics, R. D. Gardi Medical College & C. R. G. Hospital & Associated Charitable Hospital, Ujjain (M.P.)
  • Patidar A Study performed at Department of Orthopaedics, R. D. Gardi Medical College & C. R. G. Hospital & Associated Charitable Hospital, Ujjain (M.P.)
  • Jain A Study performed at Department of Orthopaedics, R. D. Gardi Medical College & C. R. G. Hospital & Associated Charitable Hospital, Ujjain (M.P.)
  • Bhinde S Study performed at Department of Orthopaedics, R. D. Gardi Medical College & C. R. G. Hospital & Associated Charitable Hospital, Ujjain (M.P.)
  • Agrawal A Study performed at Department of Orthopaedics, R. D. Gardi Medical College & C. R. G. Hospital & Associated Charitable Hospital, Ujjain (M.P.)
  • Jain P Study performed at Department of Orthopaedics, R. D. Gardi Medical College & C. R. G. Hospital & Associated Charitable Hospital, Ujjain (M.P.)
Keywords: long proximal femoral nail, subtrochanteric femur fracture, intertrochanteric fractures, subtrochanteric fractures

Abstract

Introduction: Treatment of subtrochanteric fracture is always a challenge for orthopaedic surgeons. Use of proximal femoral nail helps to prevent excessive fracture impaction and consecutive limb shortening in unstable intertrochanteric and subtrochanteric fractures. Our study is aimed to observe the results of Subtrochanteric fractures treated by Long Proximal Femoral Nail.

Material and Method: This observational study was conducted in Department of Orthopaedics of R D Gardi Medical College & associated CRGH, Ujjain during the year July 2016 to June 2018. In this study, 32 cases of fracture subtrochanteric femur (Seinsheimer type I, II, III, IV, V) were admitted and treated by internal fixation using long PFN.

Results: Out of these 32 cases, 1 patient expired and 1 patient was lost in follow up, so our study is aimed at remaining 30 cases. Results were assessed by Modified Harris Hip Score. Modified Harris Hip Score at final follow up (6 months) was Poor in 2 (6%) cases, Fair in 3 (10%) cases, Good in 11 (37%) cases and Excellent in 14 (47%) cases. Mean Modified Harris Hip Score was 87.16.

Conclusion: Our conclusion is that in subtrochanteric fracture, Long PFN helps in achieving good biological reduction, provides stability and prevents excessive collapse & limb shortening. Thus, it helps in achieving overall good functional outcome.

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References

1. Sonu Mehta, Shoaib Shaikh. “Comparison of Intertrochanteric Nail vs Proximal Femoral Nail in Proximal Femoral Fractures.” A Prospective Comparative Study, Journal of research in Medical and Dental Science 2017 Volume5 No2.
2. Browner BD, Levine AM. Skeletal trauma: basic science, management and reconstruction, 2009 Volume 1.
3. Parker MJ, Pryor GA. Gamma vs Dhs Nailing for extracapsular femoral fractures. Int Orthop. 1996:20(3):163-168.
4. Anil Kumar Gulia, S.L. Munde. “Functional outcome of Peritrochanteric fractures fixed with Proximal Femoral Nail in a Tertiary Rural Centre.” International Journal of Enhanced Research in Medicines and Dental Care ISSN: 2349-1590, Vol. 2 Issue 7, July-2015
5. Sims SH. Subtrochanteric femur fractures. Orthop Clin Am. 2002;33:113-26.
6. Barquet A, Mayora G, Fregiero J, Lopez L, Rienzi D, Francescoli L. The treatment of subtrochanteric nonunions with the long gamma nail: twenty six patients with a minimum 2-year follow-up. J Orthop Trauma. 2004;419:185-8
7. Sensheimer F. Subtrochanteric fractures of the femur. J Bone Joint Surg Am. 1978;60:300-6
8. Parker MJ, Dutta BK, Sivaji C, Pryor GA. Subtrochanteric fracture of the femur. Injury. 1997;28:91-5.
9. Reddy KR, Dasaraiah CV, Shaik M. A study on management of extracapsular trochanteric fractures by proximal femoral nail. Journal of Orthopaedics and Allied Sciences. 2016;4:58-64
10. Umesh M. Shivanna, Girish H. Rudrappa. “A Comparative Study of Functional Outcome between Dynamic Hip Screw and Proximal Femoral Nail in Surgical Management of Per-Trochanteric Fractures”. Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 43, May 28; Page: 7489-7498.
11. Jaswinder Pal Singh Walia Himanshu Tailor, H S Mann, Avinash Chander Gupta, Jagdeep Singh Rehncy, Sargun Singh. A comparative study of 30 cases of trochanteric fracture femur treated with dynamic hip screw and proximal femoral nailing.Pb Journal of Orthopaedics Vol-XIV, No.1, 2013 6
12. Kaufer, Matheull and Sonstegard, INJURY: volume 35 Issue 10 Oct 2004
13. K. Harsha Kumar1 A study of the management of open fractures of tibia by unreamed interlocking nail, 2015Month :SeptemberVolume :4Issue :71Page :12428-12446
14. Christian Boldin, Franz J Seibert, Florian Fankhauser.: etal.: "The proximal femoral nail (PFN)—a minimal invasive treatment of unstable proximal femoral fractures . Acta Orthop Scand 2003; 74(1): 53 - 58.
15. Schipper I B etal Treatment of Unstable trochanteric fractures :JBJS 2004; 86 B : 86 – 94
16. Pavelka T, Kortus J, Linhart M. Osteosynthesis of proximal femoral fractures using short proximal femoral nails. Actachir Orthop Traumatol Cech. 2003; 70(1):31-8
17. Velasco RU, Comfort TH. Analysis of treatment problems in subtrochanteric fractures of the femur. J trauma. 1978;18(7):513-23
18. Al-yassari G, Langstaff RJ, Jones JW, AL-Lami M. The AO/ASIF proximal femoral nail for the treatment of unstable trochanteric femoral fracture. Injury. 2002;33(5):395-9.
19. Chopra B.L.et al. Proximal Femoral Nail – outcome and complications: a prospective study of 125 cases of proximal femoral fractures. Int J Res Orthop. 2017 Sep;3(5):973-978
20. Batra AV et al. Our experience of management of subtrochanteric fractures of femur by proximal femoral nail. Int J Res Med Sci. 2015 Sep;3(9):2164-2168
21. Shakeel Ahmad, Rajinder Singh et al. Management of Subtrochanteric Fractures with Long PFN : Union Rates and Functional Results. Int J Cur Res Rev Vol9 Issue 9 May 2017
22. S Laxmi Narayana, M Anil Kumar et al. Intertrochanteric and subtrochanteric fractures outcome on surgery. IAIM, 2016; 3(8): 228-235.
23. Dr. Mukesh Tiwari, Dr. Gaffar Khan et al. A prospective study of functional & radiological outcomes of subtrochanteric femur fractures treated by proximal femoral nailing. IJOS 2016; 2(4): 278-284.
24. Ekstrom W, Karlsston-Thur C, Larsson S. Functional outcome in treatment of unstable trochanteric and subtrochanteric fractures with the proximal femoral nail and the Medoff sliding plate. J Orthop Trauma. 2007;21(1):18-25.
25. Menzes DF, Gamulin A, Noesberger B. Is the proximal femoral nail a suitable implant for treatment of all trochanteric fractures? Clin Orthop Relat Res. 2005;439:221-7.
26. Domingo LJ, Cecilia D, Herrera A, et al. Trochanteric fractures treated with a proximal femoral nail. Int Orthop 2001;25(5):298-301.
27. Fogagnolo F, Kfuri M Jr, Paccola CA. Intramedullary fixation of pertrochanteric hip fractures with the short AO/ASIF proximal femoral nail. Arch Orthop Trauma Surg. 2004;124(1):31-7.
28. Werner-Tutschku W, Lajtai G, Schmeidhuber G, Lang G PFN. Unfallchirurg. 2202;105:881-885.
29. Simmermacher RK, Bosch AM, Van der Werken C. The AO/ASIF proximal femoral nail: A new device for the treatment of unstable proximal femoral fractures. Injury. 1999;30:327-32
30. W.M. Gadegone, Y.S. Salphale. : Proximal femoral nail – An analysis of 100 cases of Proximal femoral fractures with an average follow up of 1 year.; International Orthopaedics 2007; 31 : 403 – 408
31. Seinsheimer, F ., III: Subtrochanteric fractures of the femur. J.Bone Jt. Surg., 60-A: 300-306, 1978.
Published
2024-01-31
How to Cite
1.
Singh V, Rathore S S, Patidar A, Jain A, Bhinde S, Agrawal A, Jain P. Functional and radiological outcome of long proximal femoral nail in subtrochanteric femur fracture. ojmpc [Internet]. 2024Jan.31 [cited 2024Dec.22];29(02):37-3. Available from: https://ojmpc.com/index.php/ojmpc/article/view/176
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Original Article