scholarly journals Functional outcome of intertrochanteric fractures in elderly patients with proximal femoral nail: retrospective study

2019 ◽  
Vol 5 (4) ◽  
pp. 619
Author(s):  
Angatha Kumar Murugesan ◽  
Rajesh Govindasamy ◽  
Patel Yahya Ismail
Keyword(s):  
Retrospective Study ◽  
Elderly Patients ◽  
Fracture Pattern ◽  
High Rate ◽  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Non Union ◽  
Femoral Nail ◽  
Varus Displacement ◽  
One Year

<p class="abstract"><strong>Background:</strong> Intertrochanteric fractures are disabling injuries in elderly population and they are the most frequently operated fracture type which has the highest postoperative fatality rate of all surgically treated fractures. The objective of the study was to evaluate the functional outcomes of intertrochanteric fractures treated with proximal femoral nail (PFN) in elderly patients.</p><p class="abstract"><strong>Methods:</strong> A retrospective study of 24 patients, all above 60 years treated with PFN between March 2016 to April 2018. Data collected include age, sex, mechanism of injury, type of fracture pattern according to Boyd and Griffin’s classification. Patients were followed up at intervals of 6, 12, 18 and 24 weeks and final results were evaluated using Kyle’s criteria at the end of 24<sup>th</sup> week. All patients had a minimum follow up of one year.<strong></strong></p><p class="abstract"><strong>Results:</strong> The study included 24 patients, 10 males, 14 females with mean age of 75.77 years (range: 60-82 years). The fracture union rate was 96% and average union time was 14.2 weeks. Our results were excellent (80%), good (8%), fair (8%) and poor (4%). Our complications include thigh pain (20%) shortening (20%), varus displacement (8%), knee and hip stiffness (8%), z effect (4%) and non-union (4%).</p><p class="abstract"><strong>Conclusions:</strong> PFN is a reliable fixation in intertrochanteric fractures only after good intraoperative reduction leading to high rate of bone union and with reduced rate of implant failure or complications.</p>

scholarly journals Impact of Wedge Effect on Outcomes of Intertrochanteric Fractures Treated with Intramedullary Proximal Femoral Nail

2021 ◽  
Vol 10 (21) ◽  
pp. 5112
Author(s):  
Shen-Ho Yen ◽  
Cheng-Chang Lu ◽  
Cheng-Jung Ho ◽  
Hsuan-Ti Huang ◽  
Hung-Pin Tu ◽  
...  
Keyword(s):  
Femoral Shaft ◽  
Lateral Wall ◽  
Fracture Pattern ◽  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Neck Shaft Angle ◽  
Femoral Nail ◽  
Increase Risk ◽  
One Year ◽  
Wedge Effect

The purpose of this study is to investigate the risk factors for wedge effect and its relevance between blade cut-out in patients with intertrochanteric fractures (ITF) treated with proximal femoral nail antirotation II (PFNA-II). A total of 113 patients with ITF treated with PFNA-II between 2012 and 2016 were retrospectively analyzed. Radiographic variables including preoperative fracture pattern, fracture classification, lateral wall fracture, and postoperative neck–shaft angle (NSA), femoral offset (FO), blade cut-out, and Parker’s ratio were measured for analysis. An average of 4.16° of varus malalignment in NSA and 5.5 mm of femoral shaft lateralization in FO was found post-operatively. The presence of lateral wall fracture was significantly related to post-operative varus change of NSA (p < 0.05). After at least one year of follow up, the blade cut-out rate was 2.65% (3/113), and Parker’s ratio was significantly higher in patients with blade cut-out (p = 0.0118). This study concluded that patients with ITF-present preoperative lateral wall fracture and postoperative higher Parker’s ratio in AP radiography showed higher incidence of wedge effect that might increase risk of blade cut out.

scholarly journals Treatment of stable and unstable intertrochanteric fractures using proximal femoral nail and their functional assessment using modified Harris hip score

2018 ◽  
Vol 5 (1) ◽  
pp. 162
Author(s):  
Lakshya P. Rathore ◽  
Lokesh Gupta ◽  
Sanjay Thakur ◽  
Sandeep Vaidya ◽  
Devender Sharma ◽  
...  
Keyword(s):  
Intertrochanteric Fracture ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Functional Evaluation ◽  
Intertrochanteric Fractures ◽  
Good Reduction ◽  
Non Union ◽  
Femoral Nail ◽  
Modified Harris Hip Score ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Intertrochanteric fracture is common injury and is found in both elderly and the young. Proximal femoral nail (PFN) has been in widespread use for the same in the recent past. There are advocates both for and against this implant. The aim was to study the results of PFN in the treatment of intertrochanteric fractures and their functional evaluation using the modified Harris hip score.</p><p class="abstract"><strong>Methods:</strong> A prospective study done on 104 patients operated for intertrochanteric fractures with PFN. Patients were followed up at 6 weekly intervals and evaluated at each visit using the modified Harris hip score (HHS).<strong></strong></p><p class="abstract"><strong>Results:</strong> The study consisted of 104 patients aged from 36 to 96 years with average age of 67.8 years. Most patients belonged to 60-80 years category. Malunion was observed in three patients (2.8%) and non union was not seen in any patient. Excellent to good results were seen in 73% patients 18% patients had a fair outcome, 7.7% had poor and 2% patients had very poor outcome.</p><p class="abstract"><strong>Conclusions:</strong> PFN is a good implant for intertrochanteric fracture treatment that demands a sound technique and a good reduction prior to insertion. The assessment of results using HHS has been too similar to those obtained using Kyle’s criteria in the previous studies, proving its role in the same.</p><p> </p>

scholarly journals A clinical study to evaluate the effectiveness of the short proximal femoral nail in the management of unstable intertrochanteric fractures

2019 ◽  
Vol 5 (2) ◽  
pp. 303
Author(s):  
Ahmed Rayan Jelani ◽  
Mohammed Ismail Hathiwale ◽  
Vishwas Vittal Mundewadi ◽  
Owais Ahmed
Keyword(s):  
Soft Tissues ◽  
Surgical Techniques ◽  
Delayed Union ◽  
High Rate ◽  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Asian Patients ◽  
Type Iv ◽  
Femoral Nail ◽  
Screw Breakage

<p class="abstract"><strong>Background:</strong> The objective was to study the effectiveness and drawbacks of short proximal femoral nail in the management of unstable intertrochanteric fractures.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted in the department of orthopaedics Al-Ameen medical college, Vijayapura, Karnataka, India from July 2010 to June 2017. Total 175 patients (130 males and 45 females) aged between 41 to 80 years with unstable Intertrochantreric fracture (155 had type IV and 20 had type III according to Boyd and Griffin classification). All patients were operated using Short proximal femoral nail and followed at least for a minimum period of 6 months and were evaluated radiologically and clinically by Kyle’s Criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> Anatomical reduction was achieved in 125 patients, 105 (60%) had no complications post operatively. Complications included 5 cases of avascular necrosis and screw cut out, 5 cases of delayed union, 5 cases of Z-effect, 20 cases of varus malunion, 10 cases of antirotation screw breakage, 5 cases of distal bolt breakage and 15 cases with lateral thigh discomfort. 125 patients had No shortening and the average shortening was 0.34 cm, average time of union was 19.26 weeks (15-30 weeks) in 170 cases. At the end of 6 months, good to excellent results were seen in 71.5% of cases, 57% patients returned to their pre injury functional level.</p><p class="abstract"><strong>Conclusions:</strong> Short proximal femoral nail provides good fixation for unstable intertrochanteric fractures, if proper pre-operative planning, good reduction and surgical techniques are followed leading to high rate of bone union and minimal soft tissues damage especially for Asian patients with relatively small femora.</p>

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