Comparison of radiological outcome of unstable Intertrochanteric femur fractures in elderly patients treated with Indian and Foreign Cephalomedullary nails

Abstract

Aim of study: Purpose of study was to compare the radiological outcome of unstable intertrochanteric fractures in the patients treated by Indian and Foreign Cephalomedullary nails. Methods: 417 patients aged 65 years and above with unstable intertrochanteric fractures fixed with Cephalomedullary nails were analysed in two groups – {Group1-{-Indian (PFN, Gamma nail); Group-II Imported (PFNA2, AOAFN)}. Exclusion criteria included polytrauma, pathological fractures, open fractures. Data was collected from January 2011 to June 2015. Pre-op radiographs were analysed for preoperative comminution, lateral wall breach and osteoporosis (singh’s index). Post operatively radiological outcome were analysed with respect to bony union in weeks. Also complications like cut-outs, varus collapse, implant failures, nonunion with both implants were analysed in immediate postop, 6weeks, 12weeks, 18weeks, 24weeks and upto 1year. Data was analysed by statistical methods. Results: Out of 417 patients, 248were operated with Indian and 169 patients with foreign implants. Radiological union in Indian was 16.41 weeks and 15.27 weeks in Foreign (p=0.887). Varus collapse was seen in 3.6% vs 2.9% (p=0.407).Cutout in 2.4% of Indian and 2.3% in Foreign (p=0.493). Implant failures seen in 2.4% vs 1.8%. Nonunion seen in 0.8% and 1.8% (p= 0.372).Complication rates were 12.9% patients with Indian and 11.2% with Foreign implants (p=0.412).