Fracture fusion under the lens: Radiological insights into intertrochanteric healing with proximal femoral nailing

Abstract

Background: Intertrochanteric fractures, particularly unstable ones, present significant challenges in orthopedic management due to their complex biomechanics and high rates of morbidity. Proximal Femoral Nailing (PFN) has emerged as an effective surgical technique for managing these fractures, offering superior stability and facilitating early mobilization. Objective: This study evaluates the radiological and functional outcomes of unstable intertrochanteric fractures treated with PFN, assesses the time to radiological union, and identifies common complications to improve clinical practice. Methods: A prospective study of 60 patients with unstable intertrochanteric fractures treated with PFN was conducted. Radiological union was assessed based on cortical continuity and callus formation, while functional outcomes were measured using the Harris Hip Score (HHS). Data on complications and correlation between radiological and functional outcomes were analyzed. Results: Radiological union was achieved in 90% of cases within an average of 12 weeks. Functional outcomes were excellent or good in 75% of patients. Complications included implant failure (5%), malunion (5%), and superficial infections (10%). A strong correlation was observed between early radiological union and superior functional outcomes. Conclusion: PFN is a reliable and effective treatment option for unstable intertrochanteric fractures, offering excellent radiological and functional outcomes with minimal complications. Future research should explore long-term outcomes and comparative studies with other fixation techniques.