scholarly journals Functional outcome of intertrochanteric fractures treated with proximal femoral nailing and role of tip apex distance: A retrospective study

2021 ◽  
Vol 7 (2) ◽  
pp. 98-101
Author(s):  
Dr. Venugopal T ◽  
Dr. Sandesh V ◽  
Dr. Nagakumar JS ◽  
Dr. Sandesh Agarwal ◽  
Dr. Anil Kumar T
Author(s):  
Gineshmon Chandy ◽  
Saju S.

<p class="abstract"><strong>Background:</strong> Intertrochanteric fractures are one of the commonly occurring injuries in elderly patients and are high among females and those with osteoporosis. They were treated with either dynamic hip screw (DHS) fixation or proximal femoral nailing (PFNA2) here at our institution. The study was conducted in order to find which method of surgical fixation has better functional outcome.  </p><p class="abstract"><strong>Methods:</strong> Total 96 patients of intertrochanteric fractures admitted during the study period of November 2017 to April 2019 were included for the study. These patients were randomly divided into two groups; DHS was used as implant in group1 and PFNA2 in group 2. Postoperatively patients were followed up after 1 month, 3months and 6 months of the surgery and were assessed using Harris hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Harris hip score was higher with PFNA2 group compared to DHS group in all follow-ups. In unstable fractures DHS group had poor outcome compared to PFNA2. Radiological union occurred in 27.1 % cases by 3 months and 72.9% cases by 6 months with DHS whereas 70.8% and 97.9% respectively with PFNA2.  </p><p class="abstract"><strong>Conclusions:</strong> PFNA2 gives a better functional outcome when compared to DHS. Even though DHS gives good functional outcome in stable fractures it is not so in the case of unstable fractures. The radiological union also is faster with proximal femoral nailing. Hence in our opinion PFNA2 can be the better fixation device compared to DHS especially in unstable fractures.  </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>


2021 ◽  
Vol 7 (3) ◽  
pp. 181-185
Author(s):  
Dr. BS Murthy ◽  
Dr. Ashish Sao ◽  
Dr. VA Senthil Kumar ◽  
Dr. Ravi Kant ◽  
Dr. Ozair Khan ◽  
...  

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