A study of surgical management of peritrochanteric fracture of femur with proximal femoral nail

Abstract

Peritrochanteric fractures are devastating injuries that most commonly affect the elderly population and also the young. Peritrochanteric fracture is a leading cause of hospital admissions in elderly people. The number of such admissions is on a raise because of increasing life span and sedentary habits. Conservative methods of treatment results in malunion with shortening and limitation of hip movement as well as complications of prolonged immobilization. This study was done to analyze the surgical management of Peritrochanteric fractures using Proximal Femoral Nail. This is a retrospective study of 20 cases of trochanteric and subtrochanteric fractures admitted to R.L. Jalappa Hospital and Research Centre, S.D.U, M.C, Kolar, between July 2009 to October 2011. Patients with Peritrochanteric fracture above the age of 18yrs were included while pathological fractures and patients with associated co-morbidities posing a risk for surgery were excluded from the study. In our series of 20 cases, excellent results were seen in 50% cases, good in 33.3% cases, fair in 16.7% in trochanteric fractures. In subtrochanteric fractures, excellent results were seen in 64.3%, good in 21.4% cases and fair in 14.3%. From this sample study, we consider that PFN is an excellent implant for the treatment of Peritrochanteric fractures. The terms of successful outcome include a good understanding of fracture biomechanics, proper patient selection, good preoperative planning, accurate instrumentation, good image intensifier.