Outcome Of Proximal femoral Nail in management of pertrochanteric fracture
Abstract
Background: Fractures around the trochanteric region of femur are one of the commonest fractures encountered in orthopedics. Better understanding of the biomechanics and the development of better implants have led to radical changes in treatment modalities of pertrochanteric fracture femur. This study was undertaken for evaluating the results of Proximal Femoral Nail in the management of pertrochanteric fractures by analysing the factors which influence the post-operative mobility, associated complications and to evaluate the functional outcome.
Material and Method: This prospective study was done in 50 cases of pertrochanteric fracture treated with Proximal Femoral Nail of age more than 20 years. Open, pathological fractures and age less than 20 years were excluded from the study. Outcome was assessed by modified Harris Hip Score system and radiologically for union
Results: 50 Patients of pertrochanteric fracture with mean age 70.4 year (range 25 to 95 years) were included in study. The mean delay in surgery was 3.8 days (range 2 to 8 days). The mean Harris Hip Score at final follow up was 84.32 ± 5.55. 32 (68%) patients had good outcome, 7 (14%) reported with excellent outcome and 5 (10%) had a fair outcome. Only 4 (8%) patient had poor outcome. Union was achieved in all patients in mean 12.02 weeks (range 10 to 14 weeks). The mean surgical time was 71 min (range 63 to 110 min). The mean blood loss in surgery was 180 ml (range 150 to 300 ml). Most common complications was shortening seen in 4 (8% cases), whereas varus, superficial infection and screw cut out was seen in one patients respectively, while Z effect and abductor lurch was seen in two patients each.
Conclusion: The Proximal Femoral Nail, after proper training and technique is a safe and easy implant option for treatment of complex pertrochanteric fractures which has the unique advantages of closed procedure, minimal invasive, preservation of fracture hematoma, less tissue damage, early rehabilitation and early return to work and biomechanical stable.
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References
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