Indian Journal of Orthopaedics Surgery


Management of intertrochanteric fractures with short proximal femoral nail


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Author Details: Rushikesh Lonikar, Shriniwas Yemul

Volume : 2

Issue : 4

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 381

Article End Page : 386


Abstract

Background: Intertrochanteric fracture is one of the most common fractures of the hip especially in the elderly with porotic bones, usually due to low-energy trauma like simple falls. The present study was undertaken to assess outcome of 50 patients of intertrochanteric fractures treated with short proximal femoral nail.
Methods: 50 cases of intertrochanteric fractures in adults treated by short proximal femoral nail were studied. Results assessed by Modified Harris Hip Score at the end of 12 months. Maximum age was 84 years and minimum age was 26 years. 32 were male and 18 were female. 11 of type I, 19 of type II, 12 of type III, 8 of type IV Boyd and Griffin classification were reviewed.
Result: Most common type of intertrochanteric fracture was Boyd and Griffin type II. Average time for union was 15.56 weeks. Malunion with varus angulation was seen in 4 cases. Z effect was seen in two cases. Reverse Z effect was seen in two cases. There was one case having broken implant 4 month post operatively. Shortening of more than 1 cm was seen in five cases. 70% excellent and good results were obtained among all cases and 62% excellent and good results were obtained in unstable type 3 and type 4 fractures.
Conclusion: The rigid fixation, more efficient load transfer, shorter lever arm of SPFN improves stability of fracture. These features makes SPFN very suitable implant for unstable intertrochanteric fractures. Less operative time, less blood loss, decreased complications makes short PFN superior implant for stable and unstable intertrochanteric fractures.

Keywords:
Intertrochanteric fracture, Hip, Short proximal femoral nail