Prospective study of proximal femoral nail in management of trochanteric and subtrochanteric fractures of femur
DOI:
https://doi.org/10.7439/ijbar.v6i4.1934Abstract
Aims: 1) Evaluation of Effectiveness and strength of Proximal Femoral nail in management of Trochantric and Sub-Trochantric Fractures. 2) Early mobilization and functional recovery of patient Objectives: 1) Stable Internal Fixation designed to fulfill biomechanical demands. 2) Toassist and enhance fracture healing. Method: It is a prospective study carried out from 2008 to 2014 in the Dept. Of Orthopaedics, RMC, Loni. Total 39 cases were treated. Boyd and Griffins classification is used. Majority of cases were from of 5th -8th decade of life. Stability of fractures is judged by presence of posterior-medial femoral cortex integrity. In all cases standard 25 mm PFN of 1350 /1300 were used. Results: After average follow-up of one year good to Excellent Hip range of motion was seen in 36 cases. All cases showed fracture union. No Z effect seen in any case. Except 2 cases which showed Reverse z effect and in 1 case nail breakage was seen without affecting functional abilities. Average fracture union time was 16 weeks. Conclusion: Proximal Femoral Nail is biomechanically sound fixation, minimally invasive which permits early mobilization, prevents excessive varus collapse at fracture site, produces less stress riser effect below tip of nail. But it also appears from this series that Indications of fixation are limited, excessive Lateral cortex comminution may limit its use. Still Proximal femoral nail is to be time tested to call it as best treatment modality for inter torchanteric and subtrochanteric fractures.Downloads
References
Ansari Moein CM, Verhofstad MHJ, Bleys RLAW, Werken C van der, Soft tissue injury related to the choice of entry point in ante grade femoral nailing; pyriform fossa or greater trochanter tip. J Clin Orthop Injury 2005; 36:1337
Al-Yassari G, Langstaff RJ, Jones JW, Al-Lami M. The AO/ASIF proximal femoral nail (PFN) for the treatment of unstable trochanteric femoral fracture. Injury 2002; 33:395-399.
Babhulkar Sudhir S. Management of trochanteric Fractures. Indian Journal of Orthopaedics 2006;40(4): 210-218.
Ballmer FT, Ballmer PM et al. Pauwels osteotomy for nonunions of the femoral neck. Orthop Clin North Am. Oct. 1990; 21, 4: 759-767.
Banan H, Al-Sabti A, Jimulia T, Hart AJ. The treatment of unstable, extracapsular hip fractures with the AO/ASIF proximal femoral nail (PFN)
Brumback RJ, Uwagie-Ero S, Lakatos RP, Poka A, Bathon GH, Burgess AR. Intramedullary nailing of femoral shaft fractures. Part II: Fracture-healing with static interlocking fixation. J Bone Joint Surg (Am). 1988; 70:1453-62.
Boriani S, Bettelli G, Zmerly H, Specchia L, Bungaro P, Montanari G, et al. Results of the multicentric Italian experience on the Gamma nail: a report on 648 cases. Orthopedics 1991; 14:1307
Sadowski Cal, Saudan M, Riand N, Stern R, Hoffmeyer P. Treatment of Reverse Oblique and Transverse Intertrochanteric Fractures with Use of an Intramedullary Nail or a 95
Schipper IB, Steyerberg EW. Treatment of unstable trochanteric fractures: Randomised comparison of the gamma nail and the proximal femoral nail. J Bone Joint Surg Brit 2004; 86: 86-94.
Gadegone Wasudeo M, Salphale Yogesh S. Short proximal femoral nail fixation for trochanteric fractures, Journal of Orthopaedic Surgery 2010; 18(1):39-44.
Seinsheimer F. Subtrochanteric fractures of the femur. J Bone Joint Surg Am 1978; 60: 300-6.
Minos Tyllianakis, Andreas Panagopoulos, Andreas Papadopoulos, Socratis Papasimos, Konstantinos Mousafiris from the University Hospital of Patras, Greece. Treatment of extracapsular hip fractures with the proximal femoral nail (PFN) : Long term results in 45 patients Acta Orthop. Belg., 2004, 70, 444-454.
Velasco RU, Comfort TH. Analysis of treatment problems in subtrochanteric fractures of the femur. J Trauma. 1978;18:513.
Gadegone W M, Salphale Yogesh. Proximal femoral nail
Zickel RE. An intramedullary fixation device for the proximal part of the femur: Nine years experience. J Bone Joint Surg (Am). 1976; 58: 866- 872.
Minos Tyllianakis, Andreas Panagopoulos, Andreas Papadopoulos, Socratis Papasimos, Konstantinos Mousafiris from the University Hospital of Patras, Greece, Treatment of extracapsular hip fractures with the proximal femoral nail (PFN): Long term results in 45 patients, Acta orthop. Belg, 2004; 70: 444-454.
Terry Canale S, James H Beaty, Campbell
Anna Nilsdotter, Ann Bremander. Measures of Hip Function and Symptoms American College of Rheumatology, Arthritis Care & Research 2011; 63 (S11): S200
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).