Results of proximal femoral nailing in subtrochanteric fracture of femur in adults

Abstract

Introduction: Subtrochanteric fractures occur in a zone extending from the lesser trochanter to 5 cm distal to the lesser trochanter, however, extension into the intertrochanteric region is common. The deforming forces on both the proximal and distal segments are difficult to control due to peculiar muscle insertion to the proximal and distal fragments. This study aims to assess the effectiveness of Proximal Femoral Nailing (PFN) for the treatment of subtrochanteric fractures of femur. Materials and Methods: This is a prospective study of evaluation of results of 32 patients who sustained subtrochanteric femur fracture treated with PFN at our institute from June 2018 to May 2020. All the patients in this study were above 18 years of age including both genders. All closed fractures and open Grade 1 and 2 fractures according to Gustilo–Anderson classification were included. Results: In this study of 32 patients, the mean age was around 3rd and 4th decade of life and Road traffic accidents was the major cause of injury (high-velocity trauma). The average radiological union time was 15.9 weeks. In 2 (6.24%) patients, there was postoperative infection and 3 (9.36%) patients had broken implant and 1 (3.12%) patient had nonunion. According to Harris hip score, 29 (90.6%) patients showed excellent-to-good results. Conclusion: PFN is a closed intramedullary nailing procedure which achieves biological fracture fixation with minimal blood loss, preserving the fracture hematoma and thus aiding in healing of the fractures. It provides good axial as well as rotational stability.