Intramedullary Nailing of Subtrochanteric Fractures: Our Experience

Abstract

To study clinicoradiological outcome of subtrochanteric femur fractures following intramedullary nailing. This was a prospective study of 22 cases of subtrochanteric fractures admitted and operated by intramedullary nailing at Southern Railway HQ Hospital, Chennai, between June 1, 2017, and May 31, 2018. The mean age distribution was 65.09 ± 17.84 years with 12 females and 10 males. According to Seinsheimer classification, there were six cases of type II, seven cases of type III, three cases of type IV, and six cases of type V. Intraoperative reduction techniques included closed reduction in 25% of subjects, limited open reduction in 50% and open reduction, augmentation with cerclage wiring in remaining 25%. Radiographic examination using radiological union score of hip (RUSH) was done to evaluate fracture union at monthly follow-up. Our mean time for union was 13.86 ± 3.8 weeks. Functional recovery was evaluated by the Harris hip scoring (HHS) system at 1, 3, 6, and 12 months postoperatively. The mean HHS at 6 months and 12 months were 81.57 ± 12.39 and 87.33 ± 8.2, respectively. Excellent to good functional outcome was seen in 76% of cases. There were two patients with superficial infections, one case of foot drop, and another case of lag screw cut-out. The mean shortening noted at final follow-up was 1.548 ± 0.57 cm. An intramedullary nail is an efficient device for the treatment of subtrochanteric fractures with high rate of bony union provided optimal reduction of the fracture and good positioning of the nail and screws is achieved. Basani V, Kumar MR, Dhanalakshmi D, et al. Intramedullary Nailing of Subtrochanteric Fractures: Our Experience. J Orth Joint Surg 2019;1(1):15–21.