Functional and radiological outcome of subtrochanteric fracture treated with proximal femoral nail

Abstract

Subtrochanteric fractures are one of the common fractures encountered in general population following a fall due to high velocity injury warranting immediate and active intervention. The main benefit of Proximal Femoral Nailing is being a closed technique offering an excellent reduction at the fracture site and adequate strength for weight bearing even in unstable hip fractures. This intramedullary device is proven to be biomechanically superior to DHS which is an extramedullary device in the treatment of subtrochanteric fractures. The objective of this study is to analyse and evaluate the functional and radiological outcome of subtrochanteric fracture treated with proximal femoral nail. A study population was selected and was carried out with a total of 25 patients (male: 20, female: 5) treated with proximal femoral nail from the year 2015-2016. All the patients were selected based on inclusion criteria such as closed fractures of less than 3 weeks and age above 25. The appropriate selected patients were assessed both clinically and radiologically at regular intervals of 4wks, 8wks, 12wks, 16wks and 20wks. The functional outcome was assessed using Harris Hip score. From our selected study sample we found majority of the patients were unstable fractures (70%) and others were stable fractures (30%). Based on the union, 50% of patients showed full union by 10 to 15 weeks and 35% showed full union by 16 to 20 weeks. We had 95% of the patients with good anatomical results and 50% of the patients with excellent functional results. PFN is a quite safe, well tolerated and effective instrumentation useful in the treatment of all subtrochanteric fractures. Being a closed intramedullary procedure early mobilization and rehabilitation is possible with early restoration of premorbid functions.