Assessing the Initial Response: Intertrochanteric Fractures Managed with Proximal Femoral Nail

Abstract

Background: The current investigation involved 41 patients diagnosed with intertrochanteric fracture, all of whom underwent surgical management with Proximal Femoral Nail (PFN). These patients were then monitored for a duration of 12 weeks post-operation, with 17 being male and 24 females. Aim & Objective: This observational and follow-up study took place within the Department of Orthopaedics at the Himalayan Institute of Medical Sciences, Dehradun, spanning a period of one year. Materials and Methods: A longitudinal analytical study was carried out in Orthopaedics department (HIMS). Patients with trochanteric fracture classified by AO classification were included in this study. Patients were followed up at 6th week, and 12th week. They were assessed clinically on the basis of Harris hip score and radiologically on the basis of femoral neck shaft angle and union Harris hip score is a tool used to calculate functional outcome in patients undergoing hip surgeries. Results: Intertrochanteric fractures was more common in old age group with most of patients in age group of 60-80 years. It was also concluded that Inter-trochanteric fractures are more commonly seen in females as compared to males. According to AO classification, AO31A2 was the most common type of fracture seen followed by AO31A1. The mean value of neck shaft angle in immediate post op was 127.68 + 4.94 and at 12 weeks post-operatively was 124.72 + 5.86 which was found to be a significant change. Average Harris hip score was found to 61.95 + 14.93 with approximately half of patient having poor grade of functional outcome with rest having fair to good grad. Union rate at 12 weeks of follow up in present study was found to be 61%. Conclusion: Complication rates in this study seen after intertrochanteric fractures treated with PFN was found to be 21.9% which included infection, screw backout, Limb length discrepancy and joint stiffness.