Retrospective critical analysis of treatment of closed extra capsular proximal Femur fractures with proximal femur nail at rural teaching setup

Abstract

Background: For extracapsular proximal femur fractures, the treatment options are innumerous, though the implant choice is debatable. In our institute we use proximal femoral nail for the treatment of extracapsular proximal femur fractures. Choosing most suitable implant for such fractures specially in old aged osteoporotic patients till date puts the surgeons in great dilemma. Aim & Objective: To study the clinical results and functional outcome of proximal femoral nail in extracapsular proximal femur fractures routinely used in our institute and to review the available literature. Material & Methods: This study consists of 60 patients who had undergone treatment of proximal femur fractures. Males constituted 70% of the study and 43.6% of the patients were more than 60 years old. Clinical outcome and functional results were evaluated by using Harris Hip scoring system. Results: Mean duration of surgery was 93 min.Post-operative complication rate was 6.7% which was superficial infection. Average time of union is 11.7 weeks. One patient had shortening of 2 cms and 2 patients had shortening of 1 cm. According to the Harris Hip Score we got excellent result in 70% and good result in 20%. Conclusion: Proximal femur fracture is common in elderly due to osteoporosis and mostly occurs due to trivial fall. PFN being a closed procedure, the amount of blood loss and duration of surgery was lesser. PFN is technically easier, with least complications even on follow up. PFN achieved the best clinical results and highest functional scores. Hence we conclude that PFN is the treatment of choice in proximal femur fracture.