Study of surgical management of pertrochanteric fracture in our institute with proximal femoral nail

Abstract

Background: Pertrochanteric fracture are devastating injuries that most commonly affect the elderly and also young. Numerous variations of intramedullary nails have been devised to achieve a stable fixation and early mobilization of pertrochanteric fractures; among these, the proximal femoral nail (PFN), devised by the AO/ASIF group in 1996, has proven to be a promising implant in per-, inter-, or subtrochanteric femoral fractures. Hence; the present study was conducted for assessing the surgical management of pertrochanteric fracture in our institute with proximal femoral nail.Methods: This was a prospective study of 20 cases of trochanteric and sub trochanteric fractures admitted to Akash institute of medical sciences and research centre between January 2017 to December 2018. Cases were taken according to inclusion and exclusion criteria. i.e. patients with pertrochanteric fractures above the age of 18 years and post traumatic pertrochanteric fractures.Results: In our 20 cases there were 15 male and 5 female, maximum age of 90 years and minimum age of 23 years, most of the patients were between 30 to 65 years. Mean age of 50.3 years.70% of cases were admitted due to RTA and 14 were sub trochanteric. In trochanteric class 83.3% were Boyds and Griffith type 2, 16.67% were B type 3and in subtrochanteric class 7.1% were type 1, 21.4% were Sinsheimer type 2a, 28.6% were 2b, 21.4% were 3a, 7.1% were type 3b and 14.3% were type 4. Mean duration of hospital stay is 20.67 days and mean time of full weight bearing is 16.3 weeks. Excellent results were seen in 50% cases, good in 33.3% cases fair in 16.7% in trochanteric fractures. In subtrochanteric fractures excellent results were seen in 64.3% good in 21.4% cases and fair were seen in 14.3%.Conclusion: We consider that PFN is an excellent implant for the treatment of pertrochanteric fractures. The term successful outcome includes a good understanding of fracture biomechanics proper patient selection good preoperative planning accurate instrumentation, good image intensifier.