Complications involved in treatment of sub trochanteric fractures by ORIF with long PFN

Abstract

Background: Subtrochanteric fractures have a tremendous impact on both the health care system and society in general. Accurate reduction and internal fixation by DHS is the ideal choice. Methodology: This is a prospective study of 20 cases of Subtrochanteric fracture admitted to Kims. Hubli between Nov 2008 to Aug 2010 treated with L.Proximal femoral nail by open method. Cases were taken according to inclusion and exclusion criteria, i.e fresh subtrochanteric fracture in adults. Pathologic fractures, multiple fractures, fractures in children, old neglected fractures were excluded from the study. Objectives of study was to study subtrochanteric fractures and to determine effectiveness of L.PFN in tretment of subtrochanteric fractures by ORIF.Results: Our study constituted 20 subtrochanteric fractures of which, 40% were Russell and Taylor type IA, 35% were type IB, and 25% type IIA. Mean duration of hospital stay was 24 days and mean time for full weight bearing was 14 weeks. Good to excellent results were seen in 85% of subtrochanteric fractures. Even though Proximal Femoral nailing is associated with Technical and mechanical complications, it were mostly related to the operative technique and the type of fracture and preoperative reduction of the fracture. Results of Proximal femoral nail fixation for subtrochanteric femur fractures are promising if a carefully pre-meditated operative plan is made. Conclusion: Most of the complications of proximal femoral nailing are surgeon and instruments related which can be cut down by proper patient selection and good preoperative planning and restoring the anatomical alignment.