A RETROSPECTIVE STUDY ONFUNCTIONAL OUTCOME OF OPERATED INTERTROCHANTERIC FEMUR FRACTURES REDUCEDWITH A POSITIVE BEAK VS NEUTRAL VS NEGATIVE BEAK - AN ARTICLE AND REVIEW OF LITERATURE

Background: Inter-trochanteric fracture is one of the most common fractures in elderly population around the world due to global rise of osteoporosis, which is generally due to a simple slip and fall in the house hold[1]. It is growing to be a disease burden for orthopedics of our era to manage. With its rise Understanding the important factors in management of IT fracture like stability, reduction, role of posterior-medial wall support, intact lateral wall configuration, will help in choosing implant for better outcome ,thus helping to achieve better post operative results[2]. Hence, understanding the role of posteriomedial wall support in IT fracture reduction in terms of positive, neutral(anatomic) or negative beak and its impact on the post operative fracture stability and early ambulation is of great importance. We conducted a retrospective comparative study in our institution to study the outcome of these configuration and its effect post operatively. Methods: A retrospective comparative study was conducted on 60 patients with Intertrochanteric fracture(38 males and 12 females with a mean age of 64.8years) without any associated fractures in elderly population in a time frame between February 2019 to August 2021 using Cephalo-mudullary nailing and Sliding hip screw in our institution. The subject population was graded into 3 groups based on the postero medial cortical wall support in post operative fracture reduction into positive, neutral(anatomic) and negative beak configuration and its effects on post operative fracture stability and early mobilization. Results: In the post operative analysis it was found that the 24 subjects who had positive configuration in the neck shaft angle versus 16 neutral(anatomic) and 10 negative configuration in their neck shaft angle had a superior and better outcome in terms of early ambulation and better long term stability without any statistical differences in terms of age, sex, post traumatic day or any co-morbidities. Conclusion: Thus, we concluded that the fracture reduction with positive reduction achieved a greater stability in terms of early mobilization and better post operative stability and fracture healing than the neutral and negative neck shaft angle. Further it was seen that neutral configuration also had a superior advantage over negative configuration in post operative follow up with a lesser incidence of varus collapse or implant failure.