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Category: Volume 07 Issue 09 September 2019
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Title: A clinical study of management of unstable Intertrochantric Fractures with Proximal Femoral Nail

Authors: Dr Jaising Rathod, Dr B Vishwanath Naik, Dr Sandeep Vemula

 DOI: https://dx.doi.org/10.18535/jmscr/v7i9.31

Abstract

    

The objective of the present study was to evaluate the efficacy of proximal femoral nail in the management of unstable intertrochanteric fractures of the hip in different age group and to determine the clinical, radiological and functional outcomes at the end of 6 months of follow up.

Methods: This is a prospective study was done in the Department of Orthopedics Kakatiya Medical College and Mahatma Gandhi Hospital, Warangal. The patients with intertrochanteric fractures underwent surgical treatment with the proximal femoral nail with a follow-up period of 12 months. A standard surgical approach was used during the operative procedure Quadriceps physiotherapy: Strengthening exercises, Static quadriceps exercise, and calf pumping are started soon, followed by knee and ankle mobilization on post-op day 1. Sutures were removed on 12th post-Operative day.  Patients were advised to walk non-weight bearing as soon as tolerable depending upon the fracture pattern.

Results: The total number of cases in this study was n=25 of which n= 16(64%) were males and n=9(36%) were females. Boyd and Griffin Classification of intertrochanteric fractures in the study shows type II were found the most common involving n=14 (56%) of the patients followed by type III n=5(20%). The type I were found in n=4(16%) and type IV was found in n=2(8%) The Harris hip score at the end of 6 months revealed excellent scores in 68% of the patients good score in 24%, fair score in 4% and poor score in 4% of the patients.

Conclusion: proximal femoral nail is a good choice in cases of unstable intertrochanteric fractures of femur because it serves a buttress against the lateral translation of the proximal fragments. It also replaces the comminuted lateral wall which is useful in unstable fractures. The implant temporarily compensates for the function of the medial column.

Keywords: Unstable Intertrochanteric Fractures, Proximal Femoral Nail.

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Corresponding Author

B Vishwanath Naik

Associate Professor, Department of Orthopedics, MGM Hospital Warangal-50600, India