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IP International Journal of Orthopaedic Rheumatology


Evaluation of results of “short proximal femoral nailing” in unstable trochanteric fractures


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Author Details: Santosh Kumar Sahu, Khusbu Parichha

Volume : 2

Issue : 1

Online ISSN : 2581-9151

Print ISSN : 2581-8112

Article First Page : 15

Article End Page : 27


Abstract

The incidence of the hip fracture has been rising with an aging population in many parts of the world. Growing number of population and the road traffic accidents have resulted in an enormous increase in these types of fractures. In younger patients the fractures usually result from high energy trauma like RTA and fall from height and accounts for only 10%. Older patients suffering from a minor fall can sustain fracture in this area because of weakened bone due to osteoporosis or pathological fracture and these accounts for 90%. Surgical management of trochanteric fractures aims at restoring the pre-fracture functional status of patients as far as ambulatory skills are concerned. A variety of implants of internal fixation have been employed to achieve this goal with variable success. The diversity of fixation devices available for treatment of trochanteric fractures illustrates the difficulties encountered for fixation, and the discussion about ideal implant for such cases continues. For the last 20-30 years a better understanding of the biomechanics of the fracture and the development of better implants have lead to radical changes in treatment modalities. With the thorough understanding of fracture geometry and biomechanics optimal treatment can be selected for individual cases. Unstable fracture patterns with postero-medial instability and a fracture with reverse obliquity poses specific challenges in their treatment as well as treatment outcome. Intramedullary devices, theoretically due to its position providing more efficient load transfer and shorter lever arm; can decrease tensile stress and thereby decreasing the risk of implant failure. We conducted a Prospective study, with a sample size of 60, with an aim to evaluate the functional outcome of treatment of unstable Inter-trochanteric Femoral fractures by Short Proximal Femoral Nail (PFN) in terms of maintaining of anatomy radiologically, to assess healing or union of fracture clinico-radiologically, Counteracting the per-operative and post-operative complications, to assessment of functional outcome by Harris Hip Score & Comparison of results with standard literature.