Proximal femoral nail: a minimally invasive treatment for intertrochanteric fractures.

Abstract

Background: Intertrochanteric fractures are the commonest fractures in elderly. Due to the increase in life expectancy and sedentary life style, more cases of such fractures are seen in day to day practice. Surgery is almost always the recommended treatment as morbidity and mortality associated with non-operative treatment is very high. Patients always have pre-existing co-morbidities that dictate the ultimate outcome. Our study was aimed at assessing the surgical management of inter trochanteric fractures using proximal femoral nail.
Materials and Methods: In our study patients who presented to department of orthopaedics, Katuri Medical College between January 2013 and December 2014, with intertrochanteric fractures were included and treated with Proximal Femoral Nail. Total of 82 patients were included in the study. Medically unfit patients and patients not willing for surgery were excluded from the study.
Results: 82 patients with intertrochanteric fractures with mean age of 68.8years,who underwent proximal femoral nailing between January 2013 and December 2014 were included in the study. Maximum age of the patient was 93 years, minimum age was 28 years. Majority of the patients were between 40-80 years. Of these 82 cases majority of the cases were due to slip & fall, with predominance of right side.52 % of cases were Boyd and Griffin type 2 fractures. Mean duration of hospital stay was 10.4 days. Mean time of full weight bearing was 13.6 weeks. Mean operation time was 40 .8minutes.Less blood loss of average 50.9 ml. Good to excellent results were seen in 91% of cases, with smaller incision, less blood loss, shorter operation time, early mobilisation of patient, decreased hospital stay, better wound healing & lesser postoperative complications.
Conclusion: From this study we consider all though Proximal Femoral Nail was technically demanding, with proper technique it gives excellent results. Proximal Femoral Nail was a minimally invasive excellent implant for treatment of intertrochanteric fractures.

Keywords: Intertrochanteric fracture, Minimally invasive treatment, Proximal Femoral Nail (PFN).