Clinical and Functional Outcome of Proximal Femoral Fractures Managed with Proximal Femoral Nail

BACKGROUND AND OBJECTIVES Dissatisfaction with use of a sliding hip screw in unstable fracture patterns led to the development of intramedullary hip screw devices. This design offers potential advantages like more efficient load transfer, decrease tensile strength on the implant, controlled fracture impaction, reduces amount of sliding and therefore limits limb shortening and deformity, shorter operative time and less soft tissue dissection potentially resulting in decreased overall morbidity. METHODS This is a prospective study of 30 cases of fresh intertrochanteric and subtrochanteric fractures admitted between November 2011 to May 2013. Cases were taken according to inclusion and exclusion criteria. Results were evaluated by fracture union on Xray and Harris hip score. RESULTS In our series of 30 cases there were 23 males and 7 females, maximum age of 90 years and minimum age of 22 years, most of the patients were between 41 to 60 years. Mean age of 57.7 years, of cases were admitted due to slip and fall and with X predominance of right side. Out of 30 cases 19 were intertrochanteric and 11 were subtrochanteric. CONCLUSION From this sample study, we consider that PFN is an excellent implant for the treatment of Intertrochanteric and Subtrochanteric fractures. The terms of successful outcome include a good understanding of fracture biomechanics, proper patient selection, good preoperative planning and accurate instrumentation.