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Study of Management of Subtrochanteric Fractures of the Femur in Adults Using Long Proximal Femoral Nail

Choudhari Pradeep , Choudhari Pradeep , Masand Narayan , Alawa Ankit

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Journal of Orthopedic Education 1(2):p 59-63, July - December 2015. | DOI:

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Abstract

 Background: Numerous variations of Intramedullary nails have been devised to achieve a stable fixation and early mobilization of subtrochanteric fracture, among which is the proximal femoral nail (PFN). We reported here the results of a prospective study carried out Institute on 30 consecutive patients who had suffered subtrochanteric fracture between from January 2013 – January 2015 and were subsequently treated with a PFN. Materials & Methods: The inclusion criteria being acute and/or pathological subtrochanteric femur fractures aged above 18 Years. The patients were maintained on traction preoperatively in cases whose surgical intervention was delayed for more than two days. All operations were performed under spinal/ epidural anesthesia. Postoperative mobilization was started once the patient’s conditions were favorable. Weight bearing was determined by the fracture pattern. Results: We came across 18 male patients and 12 female patients. 60% of the cases associated with RTA and 40% were associated with history of fall. The entire 30 patients with traumatic sub trochanteric fractures healed uneventfully except 2 cases of delayed union. No complication such as cut out or breakage of implant or peri implant fracture were encountered. Conclusions:  Long proximal femoral nail is the most reliable implant for sub trochanteric fractures, leading to high rate of union.The high advantages include minimal exposure, better stability and early mobilization with biological and biomechanical advantages.  

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