Prox-imal Femoral Nail in Reverse Trochanteric Femoral Fractures: An Analysis of 53 Cases at One Year Follow-Up

Abstract Treatment of reverse oblique trochanteric femoral fractures poses a lot of challenges. There have been proponents of intramedullary devices as well as extramedullary devices. We present the results of proximal femoral nailing surgery performed for reverse obliquity intertrochanteric fractures using two proximal lag screws and a nail of 250 mm. There is prospective study of fifty three patients with AO/OTA 31 A-A3 fractures being treated by proximal femoral nailing in our institute after seeking approval from the Hospital ethics board. The quality of the reduction, the operative time, complications and the functional status of the patients were the parameters on which the results were evaluated. The mean Harris hip score was 76.66 (range 70 -93) and the mean Barthel activity score was 16.21 (range 12 -20). The average surgical time was 50 minutes and the mean consolidation time was 11.5 weeks. Intramedullary nailing with proximal femoral nails seems to be a good option in the treatment of reverse obliquity intertrochanteric fractures as against the various existing options available for the management

Proximal femoral nail – an analysis of 100 cases of proximal femoral fractures with an average follow up of 1 year

Numerous variations of intramedullary nails have been devised to achieve a stable fixation and early mobilisation of pertrochanteric fracture, among which is the proximal femoral nail (PFN). We report here the results of a prospective study carried out at our institute on 100 consecutive patients who had suffered a pertrochanteric, intertrochanteric or high subtrochanteric fracture, or a combination of fractures, between December 2002 and December 2005 and were subsequently treated with a PFN. Close to anatomical reduction of the fracture fragments was achieved in 12 patients, while limited open reduction was required in 14 patients. During the follow-up period of 1 year complications occurred in 12 patients. Our results indicate the necessity of a careful surgical technique and modifications that are specific to the individual fracture pattern in order to reduce complications. Osteosynthesis with the PFN offers the advantages of high rotational stability of the head-neck fragment, an unreamed implantation technique and the possibility of static or dynamic distal locking