Outcome of subtrochanteric fracture of the femur managed with proximal femoral nail

Abraham, Vineet Thomas; Chandrasekaran, M; Mahapatra, Swagat

doi:10.18203/2349-2902.isj20161898

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…It has been found that there male predominance and more cases were more than 60 year of age followed by between 31 to 60 years. This finding is supported by work of EL-Mowfi and Eid TA et al [10] In present study trivial fall is the common mode of injury, right side is effected commonly and type 11 fracture is common then other type which is similar to the finding of LS Jiang, Sheng L et al [11] Duration of surgery and amount of blood loss was 95.636 + 16.799 min and 114.387 + 17.90 ml,which is supported by the finding of Kumar M, Akshat V, et al and EL-Mowfi and Eid TA et al [12,10] Regarding intra operative complication required open reduction was little common that is 12% then anatomical reduction failure and varus angulations which is supported by the work of Chopra BL, Kumar K et al [13] There was no incidence of non union and implant failure but delayed union malunion joint stiffness was present in less than 10% patients which corroborates with the finding of Abraham VT, Chandrasekaran M et al 14 Duration of hospital stay and Time required for full weight bearing was 19.84 + 2.4113 days and 16.04 + 4.431days respectively which corroborates with the finding of Ekström W, Karlsson-Thur C, et al [15] Regarding mobility of patients 76% were mobile and 24% were able to move with aid, which corroborates with the finding of Ekström W, Karlsson-Thur C, et al and Ramakrishnan M, Prasad SS et al [15,16] Functional outcome of treatment of subtrochantric fracture by proximal femoral nail was good in 52% patients and excellent in 36% which corroborates with the finding of Klinger HM, Baums MH, Eckert M, Neugebauer R. et al [17]…”

Section: Discussionsupporting

confidence: 58%

Evaluation of functional outcome of subtrochantric fracture of femur managed by proximal femoral nail: A prospective study

Srimannarayana¹,

Apparao²

2020

Int. J. Orthop. Sci.

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Background: Subtrochantric region is cortical in nature and vascularity is slow so healing is not as fast as highly vascular area of bone. This area of femur is subjected to stress due to its muscular insertions. So there is greater chance of fixation failure, non-union, and failure of procedure. Keeping all these in view present study has been designed to study the anatomical and functional outcome of subtrochantric fracture treated with proximal femoral nail, to access the stability of fixation and mobility of the patients and compare the result with standard treatment. Method: Patients with sub trochanteric facture admitted in the department of orthopaedics and trauma are enrolled for this study based on inclusion and inclusion criteria. Standard operative procedure was followed management of subtrochantric fracture by proximal femoral nail. Demographic, intra-operative, post-operative variavles are recorded. Result: The duration of surgery was 95.636 + 16799 minutes in present study. The mean volume of blood lost during surgery was 114.387 + 17.90 ml and regarding complication of in intra operative period 12% patient required open reduction. Regarding post operative complication no patient were presented with implant failure, malunion and delayed union was present in 10% patients. Joint stiffness and shortening of limb was present in 8% patients. Discussion and Conclusion:We can conclude that subtrochantric fracture is common in elderly and trivial fall is common cause. Intra-operative variables during proximal femoral nailing were good with less blood loss and minimum deformities. Post-operative variables like non union and joint stiffness was less. Most of the patients have good functional out come.

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Section: Discussionsupporting

confidence: 58%

Evaluation of functional outcome of subtrochantric fracture of femur managed by proximal femoral nail: A prospective study

Srimannarayana¹,

Apparao²

2020

Int. J. Orthop. Sci.

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“…In our study the average age at fracture was 43.7 years, this was low compared to that quoted by other authors in literature Abraham et al 50 years and in a study performed by parker et al it was 71 years. 14 In our study we has male preponderance of 22 cases (66.7%) out of 30 patients. Higher female preponderance was reported in a study by Boldin et al 70% and Pavelka et al…”

Section: Discussionmentioning

confidence: 47%

A study on clinical outcomes of complex subtrochanteric femoral fractures with cephalomedullary nail

et al. 2021

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Background: The aim of the study was to evaluate the clinical outcomes of complex subtrochanteric fractures treated by using cephalomedulary nail.Methods: This is a prospective observational study of 30 cases of complex subtrochanteric femoral fractures admitted to our hospital from January 2018 to June 2019. Cases were taken according to the inclusion and exclusion criteria i.e. type IV, type V Seinsheimer’s classification, above 18 years and those who are willing to participate in the study has been included and pathological fractures, open fractures were excluded. All the patients are followed up on 2 post-operative day, after 4 weeks, 8 weeks, 12 weeks and 6months. X-ray hip with thigh anteroposterior (AP) and lateral view taken during each follow up. Out comes was assessed using modified Harris hip score.Results: In our study of 30 cases there are 22 males and 8 females and the mean age of 43.7 years. 73.3% patients are due to Road traffic accidents predominance of right side. In our study 66% had type 4 Seinsheimers and 34% cases had type 5 Seinsheimers fracture. The mean duration of hospital stay was 17 days. Mean time for full weight bearing is 12 weeks. Good to excellent results are seen in 80% of type 4 subtrochanteric fractures and 75% of cases of type 5 subtrochanteric fractures. 4 cases had surgical site infection, 3 cases had varus, 1 case had developed implant failure, and 1 case had reverse Z effect.Conclusions: From this study, we conclude that proximal femoral nail is an excellent implant in the treatment of complex subtrochanteric femoral fractures the terms of successful outcome include a good understanding of fracture biomechanics, good preoperative planning and accurate instrumentation.

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“…Final result of our study, we had 26.7% excellent, 46.6% good, 20% fair and 6.7 % poor results according to Harris hip score. [5][6][7] 21 of the patients in our study were males. In all other studies also, there is a male preponderance.…”

Section: Resultsmentioning

confidence: 99%

“…6 In a study of 30 patients by Abraham et al had very good result, 9 had good results and 4 patients had moderate results and 3 had poor results. 7…”

Section: Resultsmentioning

confidence: 99%

A prospective study of management of subtrochanteric femur fracture using proximal femoral nail

et al. 2020

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Background: Proximal femur fractures present considerable challenge in management. They are due to high velocity trauma, with or without soft tissue injury and usually with a metaphyseal and diaphyseal involvement. The surgeon has to face many challenges like identifying the entry, reduction the fracture, and difficulty due to a narrow medullary canal and comminution. The present study was conducted to assess the utility and effectiveness of Proximal Femoral Nail for subtrochanteric fractures of femur.Methods: In this study a total of 30 patients with Sub trochanteric femur fracture admitted to MGM medical college and hospital from June 2015 to July 2017 were selected for treatment with proximal femur nail.Results: 30 patients were included in this study with subtrochanteric fractures of femur treated with Proximal femoral nail. Maximum 21(70%) of patients were below 61 yrs of age. Mean age was 47.9 years. There was 21 male and 9 females in the study. There were 6 patients with local complications. Final result of our study, we had 26.7% excellent, 46.6% good, 20% fair and 6.7 % poor results according to Harris hip score.Conclusions: In our study, looking at the results we found that Proximal femoral Nail proves to be a good implant in management of subtrochanteric fractures of femur. However, it is a small study to conclude anything definitely.

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Outcome of subtrochanteric fracture of the femur managed with proximal femoral nail

Cited by 7 publications

References 8 publications

Evaluation of functional outcome of subtrochantric fracture of femur managed by proximal femoral nail: A prospective study

Evaluation of functional outcome of subtrochantric fracture of femur managed by proximal femoral nail: A prospective study

A study on clinical outcomes of complex subtrochanteric femoral fractures with cephalomedullary nail

A prospective study of management of subtrochanteric femur fracture using proximal femoral nail

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