scholarly journals Management of Subtrochanteric Fracture Femur- by ProximalFemoralNailing

2022 ◽  
Vol 8 (1) ◽  
pp. 132-140
Author(s):  
Girish Sahni
Keyword(s):  
Excellent Result ◽  
Tertiary Care ◽  
Subtrochanteric Fracture ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Subtrochanteric Fractures ◽  
Femoral Nail ◽  
One Year ◽  
Modified Harris Hip Score ◽  
A Prospective Study

Background: Numerous variations of intramedullary nailing have been evolved over the years for stable fixation and early mobilisation of subtrochanteric fracture, out of which one is proximal femoral nail. Aims and objectives –We conducted this study with an objective to evaluate the results of internal fixation of subtrochanteric fractures of the femur with proximal femoral nail – AO type Design.Methods:This was a prospective study carried out at our tertiary care institute on 30 patients who had suffered subtrochanteric fracture and were subsequently treated with a proximal femoral nail (PFN). Proximal femoral nail was inserted through the tip of greater trochanter. All patients were followed up for a period of one year; at an interval of 3 months and during each follow-up visit for the functional outcome by modified Harris Hip Score, was assessed in the form of walking, squatting, sitting and rising from chair.Results:Modified Harris hip score was used for the evaluation of results in our study which showed excellent result in 21 patients (70%), good results in 3 cases(10%), fair results in 3 patient (10%) and poor results in 3 cases(10%). The mean Harris hip score in our study was 90.6.Conclusion:PFN is an intramedullary load sharing implant. Reduction and management of subtrochanteric fractures is challenging in traumatology. Proximal femoral nailing spanning whole femur with proximal and distal locking appears to be a satisfactory implant in management of fractures of subtrochanteric femur.

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 Efficacy of proximal femoral nail augmentation in unstable intertrochanteric fracture

2020 ◽  
Vol 6 (5) ◽  
pp. 1043
Author(s):  
Purushotham V. J. ◽  
M. Ayyub Khan ◽  
Navneeth Kumar
Keyword(s):  
Intertrochanteric Fracture ◽  
Femoral Fractures ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Cerclage Wire ◽  
Femoral Nail ◽  
Unstable Intertrochanteric Fracture ◽  
Male Patients ◽  
Modified Harris Hip Score ◽  
A Prospective Study

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong><span lang="EN-US">To assess the short term functional and radiological outcome of unstable intertrochanteric fracture fixation using proximal femoral nail with augmentation using Cannulated Cancellous (CC) screw or Stainless Steel (SS) wiring.</span></p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong><span lang="EN-US">A prospective study was conducted with 20 cases of unstable intertrochanteric femoral fractures from May 2017 to March 2019. Six females and fourteen male patients in the age group between 40 and 80 years were included in this study. There were 8 cases of AO31A2 and 12 cases of AO31 A3. Fracture were fixed by proximal femoral nail with augmentation by an additional CC screw or encirclage with SS wires to strengthen the lateral trochanteric wall.</span></p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong><span lang="EN-US">Fracture union was achieved in all cases with a mean period of 15.4 weeks. Patients were followed up for a period of 6 months. At the end of follow up the Modified Harris Hip Score was found to be more than 90 % in 16 cases.</span></p><p class="abstract"><strong><span lang="EN-US">Conclusion:</span></strong><span lang="EN-US"> Augmentation of proximal femoral nail in unstable intertrochanteric fracture with additional screw or cerclage wire increases the efficacy and stability of construct, aiding union and expedition of time to union.</span></p>

scholarly journals Retrospective study for the results of proximal femoral nailing in subtrochanteric fractures

2020 ◽  
Vol 6 (4) ◽  
pp. 699
Author(s):  
Manthan H. Mandalia ◽  
Hasmukh L. Kubavat ◽  
Nirav Trivedi
Keyword(s):  
Retrospective Study ◽  
Age Groups ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Stable Fixation ◽  
Early Mobility ◽  
Subtrochanteric Fractures ◽  
Femoral Nail ◽  
Intramedullary Implant ◽  
Returning To Work

<p class="abstract"><strong>Background:</strong> Subtrochanteric fractures are prevalent in young and old age groups and one of the most notorious to achieve a stable fixation which allows early union and mobilization. This was a retrospective study to analyse the outcomes of proximal femur nailing in subtrochanteric fractures and assess the functional outcome, radiological union and compare that with studies of other modalities.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study of 40 patients with sub trochanteric fractures classified by Sienshiemer classification and operated by proximal femoral nail implant. Clinical evaluation was done by Harris hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> The average union time in our study was 5.12 months lower than some of the union rates of series with other implants (AO blade plate 7.7%). The conducive environment provided by proximal femoral nail (PFN) allows early mobility, independence to the patient and lessens the complications due to the bed ridden state and decrease the time in returning to work.</p><p class="abstract"><strong>Conclusions:</strong> Our study suggests that PFN being and intramedullary implant gives stable fixation and early union as compared to extramedullary implants with less blood loss and less complications.</p>

scholarly journals Outcome of proximal femoral nail antirotation in peritrochanteric fractures: A prospective study

2021 ◽  
Vol 12 (8) ◽  
pp. 125-129
Author(s):  
Pratyenta Raj Onta ◽  
Dilip C Agarwal ◽  
Upendra Jung Thapa ◽  
Pabin Thapa ◽  
Krishna Wahegoankar ◽  
...  
Keyword(s):  
Blood Loss ◽  
Weight Bearing ◽  
Invasive Procedure ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Full Weight Bearing ◽  
Femoral Nail ◽  
The Mean ◽  
Proximal Femoral Nail Antirotation ◽  
A Prospective Study

Background: The incidence of peritrochanteric fractures are increasing worldwide. Early mobilization in these fractures prevents from other medical complications. There are many methods of treatment but the ideal method should be less invasive procedure, intramedullary device and stable fixation of fracture. Proximal femoral nail antirotation (PFNA) is biomechanically considered one of the most effective methods of treatment with promising results. Aims and Objectives: The aim of our study was to evaluate the clinical and radiological outcomes in patient who were treated with PFNA in peritrochanteric fracture. Materials and Methods: This study was a prospective study which included 37 patients, conducted in Manipal Teaching Hospital from 1st October 2019 to 30th September 2020. All the patients were clinically evaluated and detail history was obtained. After the anaesthesia clearance the patients were operated. Operating time, intraoperative blood loss and complications were noted. Postoperatively the duration of hospital stay, time of partial and full weight bearing, time for radiological union and complications were noted. At the final follow up Harris Hip Score was used for functional outcome. Results: The mean age of the patient in this study was 64 years (45-88 years). The average time to complete the surgery was 62.49 minutes (45-75 minutes) and the average blood loss was 129.32 ml (65-210 ml). Partial weight bearing was started at the mean time of 8.57 weeks (6-12 weeks) whereas full weight bearing was done at the mean of 14.43 weeks (10-20 weeks). Fracture union was seen at the average of 11.41 weeks (8-18 weeks). The mean Harris Hip score at final follow up was 84.73 (65.8-95.0) with the functional status of 35.1% excellent result, 45.9% good, 13.5% fair and 5.4% poor. Conclusion: Proximal femoral nail antirotation in peritrochanteric fracture is a good method of fixation. The procedure is easy with reduced operative time and radiation exposure. Since this is minimally invasive procedure the blood loss is very less compared to DHS or plate fixation. The patient could be mobilized early from the bed that reduced the complication of immobilization. So we strongly recommend using PFNA for fixation of peritrochanteric fracture of hip.

scholarly journals The Results of Unstable Intertrochanteric Femur Fracture Treated with Proximal Femoral Nail Antirotation-2 with respect to Different Greater Trochanteric Entry Points

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Sharan Mallya ◽  
Surendra U. Kamath ◽  
Rajendra Annappa ◽  
Nithin Elliot Nazareth ◽  
Krithika Kamath ◽  
...  
Keyword(s):  
Entry Point ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Care Hospital ◽  
Femoral Nail ◽  
Tip Apex Distance ◽  
Proximal Femoral Nail Antirotation ◽  
Modified Harris Hip Score

Background. Proximal femoral nail antirotation-2 (PFNA-2) has been widely used to treat intertrochanteric fractures with varied outcomes in the previous studies. The entry point of the nail plays an important role in achieving acceptable reduction, stable fixation, and avoiding implant related complications. This study was proposed to determine the optimal greater trochanteric entry point for PFNA-2 in unstable intertrochanteric femur fractures. Methods. We conducted an observational study on 40 patients with unstable intertrochanteric fracture treated with PFNA-2 implant in a tertiary care hospital. The patients were grouped into two based on the entry point: group L for lateral and group M for medial entry. Randomization was carried out by assigning the patients to the group by alternate allocation. The quality of reduction, tip apex distance, Cleveland index, and all the complications were noted. The final follow-up was conducted at six months. The functional outcome was evaluated using modified Harris hip score. The data analysis was performed using Student’s t-test, chi square test, and Mann–Whitney test. A P value below 0.05 was considered significant. Results. Forty patients with 20 patients treated with medial entry point were included in group M and 20 patients in group L with lateral entry point. The group L had an average tip apex distance of 20.53 and group M had 20.02 (P=0.8). The complication of screw back out was seen in 3 out of 4 patients with poor reduction in group L. As per the Cleveland index, 6 patients in each group had suboptimal position and 4 out of 6 patients in group L with suboptimal position had screw back out. The lateral cortex impingement was seen in 14 patients of group L and 6 patients in group M with significant comparison (P=0.01). Three patients in group L had varus collapse with screw back out. Also, none in group M (0.05). The average modified Harris hip score in group L at six months follow-up was 71.94 and 76.8 in group M (P=0.84). Conclusion. Overall, to achieve good quality of fixation and reducing damage to gluteus medius entry point for PFNA-2 should be 5 mm medial to the greater trochanter tip.

A PROSPECTIVE COMPARISON OF THE PROXIMAL FEMORAL NAIL VERSUS THE PROXIMAL FEMORAL LOCKING PLATE IN SUBTROCHANTERIC FEMORAL FRACTURES.

2021 ◽  
pp. 65-69
Author(s):  
Dinesh Kumar Bairwa ◽  
Jitendra Aloria ◽  
Vishnu Prasad ◽  
Ashok Kumar Tiwari
Keyword(s):  
Locking Plate ◽  
Weight Bearing ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Subtrochanteric Fractures ◽  
Femoral Nailing ◽  
Femoral Nail ◽  
Prospective Comparison ◽  
Anatomic Reduction ◽  
Proximal Femoral Nailing

BACKGROUND: Subtrochanteric fractures account for 10% to 30% of all hip fractures. The fractures were repaired with a variety of implants. Direct anatomic reduction or indirect reduction and bridge plating procedures are also possible with the proximal femoral locking plate (PFLP). Proximal femoral nails (PFN) have been demonstrated to be superior to other implants due to biomechanical advantages. The goal of this study was to compare the radiological and functional outcomes of subtrochanteric fractures treated with the proximal femoral nail (PFN) and the proximal femoral locking plate (PFLP), in order to determine which implant was the best t for the specic fracture pattern. METHODS: 50 patients with a Subtrochanteric femur fracture were operated on and treated with a proximal femoral nail and a proximal femoral locking plate (25 in each group). A 24-month follow-up was completed. The Harris Hip Score (HHS) and radiological results were used to determine the outcome. When compared to patients treated wit RESULTS: h a proximal femoral locking plate, individuals treated with proximal femoral nailing required considerably less time to achieve complete weight bearing. In patients treated with a proximal femoral locking plate, radiological union was considerably delayed compared to patients treated with proximal femoral nailing. The average HHS in the nailing group was slightly higher than in the plating group. PFN have the advantage by taking less operative time, high rate of union, mi CONCLUSION: nimal soft tissue damage, less infection rate and early postoperative rehabilitation. In our research, we discovered that both PFN and PFLP can be utilised successfully to treat Subtrochanteric fractures. In terms of anatomical alignment, limb length disparity, postoperative infection, and, most critically, the nal Harris Hip Score, there was no signicant difference between implants.

scholarly journals A prospective study of management of subtrochanteric femur fracture using proximal femoral nail

2020 ◽  
Vol 6 (2) ◽  
pp. 292
Author(s):  
Shwetabh Malik ◽  
Parimal Malviya ◽  
Alfven Vieira ◽  
Deepak Jain
Keyword(s):  
Proximal Femur ◽  
Femur Fracture ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Medullary Canal ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Subtrochanteric Fractures ◽  
Femur Fractures ◽  
Femoral Nail

<p class="abstract"><strong>Background:</strong> Proximal femur fractures present considerable challenge in management. They are due to high velocity trauma, with or without soft tissue injury and usually with a metaphyseal and diaphyseal involvement. The surgeon has to face many challenges like identifying the entry, reduction the fracture, and difficulty due to a narrow medullary canal and comminution. The present study was conducted to assess the utility and effectiveness of Proximal Femoral Nail for subtrochanteric fractures of femur.</p><p class="abstract"><strong>Methods:</strong> In this study a total of 30 patients with Sub trochanteric femur fracture admitted to MGM medical college and hospital from June 2015 to July 2017 were selected for treatment with proximal femur nail.<strong></strong></p><p class="abstract"><strong>Results:</strong> 30 patients were included in this study with subtrochanteric fractures of femur treated with Proximal femoral nail. Maximum 21(70%) of patients were below 61 yrs of age. Mean age was 47.9 years. There was 21 male and 9 females in the study.  There were 6 patients with local complications. Final result of our study, we had 26.7% excellent, 46.6% good, 20% fair and 6.7 % poor results according to Harris hip score.</p><p class="abstract"><strong>Conclusions:</strong> In our study, looking at the results we found that Proximal femoral Nail proves to be a good implant in management of subtrochanteric fractures of femur.  However, it is a small study to conclude anything definitely.</p>

scholarly journals Pattern of Ear Diseases among Paediatric ENT Patient: An Experience from Tertiary Care Centre, Pokhara, Nepal

2012 ◽  
Vol 32 (2) ◽  
pp. 142-145 ◽  
Author(s):  
B Sigdel ◽  
R Nepali
Keyword(s):  
Tertiary Care ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Suppurative Otitis Media ◽  
Ear Diseases ◽  
Paediatric Age ◽  
One Year ◽  
A Prospective Study ◽  
Nose And Throat

Introduction: Ear diseases are common in children mainly due to altered anatomy of Eustachian tube which is straighter in children as compared to that in adults. However, the cause of hearing loss in children is more varied, including the etiologies. This study was done to find out the pattern of ear diseases in paediatric age group attending ear, nose and throat OPD in a tertiary care centre in Pokhara, Nepal. Materials and Methods: This is a prospective study done in paediatric patients attending ENT OPD over a period of one year from January 2010 to January 2011. The diagnoses were made on the basis of history and clinical examination. Results were expressed in numbers and percentages. Results: Out of 1632 Pediatric ENT patients, 944 had ear diseases, 59.2% were males and 40.8% females. Wax (33.4%) was the commonest diagnosis followed by Chronic suppurative otitis media (24.3%) and Acute ottitis media (13%). Conclusion: Ear diseases are most common condition in ENT OPD among paediatric age group. Wax, CSOM and ASOM were the three most common ear diseases. J. Nepal Paediatr. Soc. 32(2) 2012 142-145 doi: http://dx.doi.org/10.3126/jnps.v32i2.5673

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