scholarly journals Functional outcome of proximal femoral nailing in inter trochanteric fractures of femur: A prospective study

2017 ◽  
Vol 3 (2e) ◽  
pp. 513-518
Author(s):  
Boblee James ◽  
Ram Prasath ◽  
mr. Vijayakumaran
Author(s):  
Shankar Linga S. ◽  
Janardhana Aithala P. ◽  
Amarnath Savur

<p class="abstract"><strong>Background:</strong> In view of the high incidence of implant failure and varus collapse seen in unstable inter trochanteric femur fractures treated with dynamic hip screw (DHS), proximal femoral nailing (PFN) has gained popularity.<sup>1,2</sup> However there is limited literature regarding functional outcome following PFN especially in Indian patients. In this study, our aim was to assess functional outcome following PFN of unstable inter trochanteric femur fractures which includes the ability to sit cross leg and squat.</p><p class="abstract"><strong>Methods:</strong> This prospective observational study was done at the associated hospitals of KMC Mangalore, spanning a time period of around 2 years, from October 2014 to July 2016. All patients who presented with isolated closed unstable inter-trochanteric fractures were included in the study. Patients were treated with proximal femoral nailing and followed up for a minimum period of 6 months. Outcome measures included Harris hip score, walking status and ability to sit cross leg and squat.<strong></strong></p><p class="abstract"><strong>Results:</strong> 40 consecutive patients (Mean age 61 years, range 25-95) were included in the study, all fractures united within 6 months. As per Harris hip score, 25 patients (62.5%) had excellent or good results, 8 patients (20%) had fair and 7 patients (17.5%) had poor results. 74% (20 out of 27) regained their gainful working status. 80% (24 out of 30) were able to squat easily  or with some  difficulty and 74% (20 out of 27) patients were able to sit crossed leg with or without difficulty. 82% (23 out of 28) regained their unassisted walking status.</p><p><strong>Conclusions:</strong> For unstable inter trochanteric femur fracture PFN gives good results in terms of union, walking ability and majority of the patients regained their pre injury activity status including squatting and cross leg sitting. </p>


Author(s):  
Santosha .

<p class="abstract"><strong>Background:</strong> Open reduction and dynamic hip screw with plate was considered as the standard method of treatment for intertrochantric fracture of femur previously. With the introduction of proximal femoral nails, closed reduction and proximal femoral nailing are used extensively for the treatment of intertrochantric fractures in the last two decades. The purpose of this study was to evaluate the functional outcome in early treatment of intertrochanteric fractures of Femur by closed reduction and proximal femoral nailing.</p><p class="abstract"><strong>Methods:</strong> Study was conducted in the department of orthopaedics in Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from August 2014 to August 2016. Forty cases of intertrochantric fractures are treated with proximal femoral nails. Patients were followed up for a period of 24 weeks. The modified Harris hip score (MMHS) was used to evaluate the functional outcome of surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> Forty consecutive patients were included in this study. Fractures were classified according to Boyd and Griffin classification system. According to the classification 16 cases were type I, 14 cases were type II, 5 were type III and 5 were of type IV. After 12 months of follow-up, all 40 patients were available for evaluation. Radiological union was achieved in a mean time of 14.5 weeks. MHHS was excellent in 13 patients good in 16 patients, fair in 8 patients and poor in 3 patients.</p><p class="abstract"><strong>Conclusions:</strong> Proximal femoral nailing systems are minimally invasive techniques with shorter operative time and good union rate.</p>


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