Functional outcome of proximal femoral nail in the management of subtrochranteric and intertrochanteric fractures of femur

Abstract

Background: The study was conducted to analyse the functional outcome of the treatment of stable and unstable Intertrochanteric and Subtrochanteric fractures of femur treated with Proximal Femoral Nail (PFN). Methods: In this prospective study, 26 patients of either sex and aged above 18 years with intertrochanteric and subtrochanteric fractures admitted to our institution were treated with Proximal Femoral Nail (PFN) from July 2008 to december 2009 and were followed up over a period of 6 months. The fractures were classified as per Boyd-Griffin and Russell-Taylor classifications. Clinical and radiographic analysis was done regularly till fracture union occurs. Assessment of the functional outcome was done by using Harris hip Scoring system at the end of 6 months. Results: Out of 26 cases, 20 were males and 6 were females, in the age group of 21-78 years with the mean age of 49.24 years. Majority (76%) of the fractures showed radiological union by 20 weeks with the mean union time of 18.52 weeks. Excellent to good results were achieved in 80% of patients as per Harris hip score. Post-operative complications like delayed/non-union were seen in two patients. No case of screw cut- out or ‘Z’ effect were seen. Conclusion: Based upon our experience and results we conclude that with good understanding of fracture biomechanics, accurate instrumentation and technique, proximal femoral nail (PFN) gives excellent clinical results in the management of all types of stable and unstable intertrochanteric and subtrochanteric fractures of femur.