Original Articles
Outcome following proximal femoral nailing with helical head screw for intertrochanteric and subtrochanteric fractures | |
Dr. Savith V Shetty, Dr.Abhishek V Shetty, Dr. Shameez Muhammed Salim, Dr. Mohammed Inayathullah Khan, Dr. Ullas Mahesh | |
Introduction: Intertrochanteric femur fracture is one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to trivial trauma. Dynamic Hip Screw (DHS) is still considered the gold standard for treating intertrochanteric fractures by many. Proximal femoral nail is a relatively newer implant designed to treat unstable intertrochanteric fractures. The present study was conducted to evaluate functional outcome in intertrochanteric femur fractures treated by proximal femoral nailing. Intertrochanteric fractures are seen commonly in two patient groups, older osteopenic patients after a low-energy fall and younger patients involved in high-energy trauma. Early surgical intervention is advocated in the majority of these patients to reduce the complications associated with long-term immobilization. Methods: The present study is a prospective study performed on in this study proximal femoral nailing with helical head screw is used to achieve initial stability and early mobilization of the patients to avoid complications. In 60 patients undergoing proximal femoral nailing with helical head screw for intertrochanteric fractures the results of surgery were meticulously followed. Functional outcome was assessed by modified Harris hip score at the end of 6 months postoperatively. Result: Total 60 patients were included,30 were females and 30 were males. Age group ranged from 18 to 90 years. Maximum patients (40.81%) were between 60 to 70 yrs age group. 57.12%of patients had Evans type I fracture and the rest (42.88%) had type II fracture. Excellent outcome observed in 30.6% patients, good in 44.9%, fair outcome in 14.2% and only 10.2% had poor outcome among 60 patients. Conclusion: It is concluded from our study that use of PFN for treatment of intertrochanteric fractures provides a good functional outcome along with advantages in terms of minimal blood loss, early weight bearing and few complications. It is the implant of choice for unstable intertronchanteric fractures. Our study concludes that proximal femoral nailing with helical head screw is the best method of treatment for intertrochanteric fracture as it leads to lesser complications. |
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