Functional Outcome And Mortality Assessment Following Proximal Femoral Nailing In Inter Trochanteric Fracture

Abstract

Intertrochanteric fractures constitute one of the most typical fractures of the hip. The incidence of fractures in the trochanteric area has risen with an increase in numbers of the older person with osteoporosis. Mortality, morbidity ratios are increasing in patients with inter-trochanteric fractures. Advanced age and associated co-morbidities are two primary added source for high mortality in trochanteric fracture patients. We conducted this study to assess the mortality rate and the functional outcome in inter-trochanteric fractures after proximal femoral nailing. This is a prospective study, in which 60 Intertrochanteric fractures of femur patients who came to our hospital EMS. Inclusion and Exclusion criteria were included in this study and were done from a period from January 2014 to July 2017. They were evaluated on each follow-up clinically using Harris Hip score and radio-logically using RUST score. The overall mortality rate at the end of the 3-year follow-up in our study is 13.3%. The factor which significantly influenced the mortality rate was Coronary artery disease. Four patients had implant-related complications. One patient developed non-union, which was later revised with Bipolar Hemi-arthroplasty. One patient developed screw back out, and two patients developed screw breakage. Results of our study concluded that elderly patients of age group 75-89 years of age were at higher risk for intertrochanteric fractures. Associated comorbid condition plays a significant role in the mortality of this fractures. In our study, coronary artery disease had a significant influence on the mortality rate for intertrochanteric fractures with a 4.63 fold rise in the mortality rate for these patients.

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“…In our study the most common mode of injury was simple fall (62.5%) where as in Huang et al study has observed both RTA and simple fall as the commonest mode of injury 6 and in the study done by Prabhakaran et al showed 76.7% patients had simple fall compared to RTA (23.3%) 2 . 66.7% had right side injury in our study.…”

“…In the study done by Prabhakaran et al majority had left side injury 55% 2 . In our study we have used AO classification to classify intertrochanteric fractures and it was found that most common type was 31A2.2 (37.5%), Aspenberg et al reported 50% of the population having 31A1 (50%) type of fracture 11 , whereas Kim et al has reported 87.5 % of fracture type 31A2 14 .…”

“…13 In Huang et al there were 67.7% female patients and 32.2% were male patients. 6 In a study done Prabhakaran et al in the year 2014-2015 showed that majority 71.7% were male 2 .…”

“…Kim et al had an average age of 80.2 years in his study group. 14 In a study by Prabhakaran et al in the year 2014-2015 showed that majority of the patients were more than 60 years of age (63.4%) 2 .…”