Abstract: Intertrochanteric fractures of femur are the most frequently operated fracture types, have the highest postoperatively fatality rate of surgically treated fractures, and have become a serious health resource issue due to high cost of care required after injury. Multiple modalities of surgical treatment are available, since the fracture patterns are not uniform and the morphology of femur has significant variations. Using reconstruction nail [proximal femoral nail] for fracture fixation, improved mobility, less blood loss was noted in among these patients.
Objective: To access the functional outcome of unstable comminuted intertrochanteric fractures of femur managed surgically using proximal femoral nailing.
Materials and Methods: This was a prospective study, conducted among 25 patients with comminuted proximal femoral fractures in the age group of 50 to 75 years. Period of study was from June 2013 to November 2014. Patients were drawn into the study from both elective and emergency groups presenting to the department of orthopedics, Father Muller Medical College Hospital, during the above mentioned period. The data was collected by interview, by analyzing case papers. Patients were followed up at intervals of 6th week, 12th week and 6 months post operatively. The outcome was assessed based on post-operative pain, return to activities of daily living, shortening of limb, range of movements, neck shaft angle, radiological union and implant position.
Results: 80% of patients have minimal pain at 12th month of follow up, following surgery. 84% of patients returns to their pre injury status in terms of daily routine activities. Only one patient showed limb shorteing of around 2 cm. 10 % of non-union noted following intramedullary fixation. Based on the kyle’s criteria 70% of patients showed excellent results.
Conclusion: Achieving adequate fracture reduction and anatomical reconstruction is vital in attaining good outcome. However appropriate fixation device has to be selected based on the fracture pattern. Patients treated by proximal femoral nailing gained better range of movements. Majority of the fractures in which near normal anatomical reconstruction was done achieved union.
Keywords: Intertrochanteric fractures, Proximal femoral nail, Non-union.
Title: Functional Outcome of Comminuted Intertrochanteric Fracture of Femur Internally Fixed Using Proximal Femoral Nail
Author: Dr. Rohit Jhamnani, Dr. Ronald JM, Dr. Harsharaj K
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
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