Free vascularized fibular graft combined with allograft increases initial stability, allows early weight bearing, has higher chances of union and is a good single-stage technique of reconstruction of distal third femur defects.

Aim of study: Purpose of study was to compare the radiological outcome of unstable intertrochanteric fractures in the patients treated by Indian and Foreign Cephalomedullary nails. Methods: 417 patients aged 65 years and above with unstable intertrochanteric fractures fixed with Cephalomedullary nails were analysed in two groups -{Group1-{-Indian (PFN, Gamma nail); Group-II Imported (PFNA2, AOAFN)}. Exclusion criteria included polytrauma, pathological fractures, open fractures. Data was collected from January 2011 to June 2015. Pre-op radiographs were analysed for preoperative comminution, lateral wall breach and osteoporosis (singh's index). Post operatively radiological outcome were analysed with respect to bony union in weeks. Also complications like cutouts, varus collapse, implant failures, nonunion with both implants were analysed in immediate postop, 6weeks, 12weeks, 18weeks, 24weeks and upto 1year. Data was analysed by statistical methods. Results: Out of 417 patients, 248were operated with Indian and 169 patients with foreign implants. Radiological union in Indian was 16.41 weeks and 15.27 weeks in Foreign (p=0.887). Varus collapse was seen in 3.6% vs 2.9% (p=0.407).Cutout in 2.4% of Indian and 2.3% in Foreign (p=0.493). Implant failures seen in 2.4% vs 1.8%. Nonunion seen in 0.8% and 1.8% (p= 0.372).Complication rates were 12.9% patients with Indian and 11.2% with Foreign implants (p=0.412).