B Mahender Reddy¹, K Vijay², C K Reddy³

¹Assistant Professor, Department of Othopaedics, Alluri Sitaramaraju Academy of Medical Sciences ,Eluru,Andhra Pradesh,²Associate Professor, Department of Othopaedics, Kamineni Institute of Medical Sciences, Narketpally,Telangana, ³Professor, Department of Anatomy, Prathima Institute of Medical Sciences, Karimnagar, Telangana,India.

Address for correspondence: Dr.B.Mahender Reddy, Assistant Professor, Department of Othopaedics, Alluri Sitaramaraju Academy of Medical Sciences, Eluru,Andhra Pradesh, India.

Email: drmahender_reddy@yahoo.com

Introduction: Intertrochanteric and subtrochanteric fractures are devastating injuries that most commonly affect elderly, but it is not uncommon in younger age. Trochanteric fractures in elderly are due to trivial fall where as in younger population it is due to high energy trauma. Treatment of these fractures especially sub trochanteric fractures is highly challenging, because there is high risk of malunion, delayed union (No-Union), implant failure etc. There are various methods of treatment available but Proximal Femoral Nail ( PFN) which is centromedullary collapsible device with additional rotation stability is biomechanically more stable implant

Material and Methods:Our study consists of 40 patients, of which 30 are trochanteric fractures and 10 are sub trochanteric fractures. In our series maximum age was 92 years and minimum age was 26 years and the mean age was 61.4 years, most of the patients were between 60 to 75 years. All the patients were treated with PFN after proper preoperative evaluation and planning. Post surgery patients were followed up at regular intervals of 4 weeks till there is fracture union and there after once in 8 weeks till one year. At every visit patient was assessed regarding hip and knee functions and fracture union.

Results: In our study average time for union was 14.6 weeks. We had one case of shortening of 1cm with near normal range of hip motion. There were no cases of non union or implant failure. Mean Harris Hip score was 89.8, which is comparable to that of Karn et al.92 (2011)

Conclusion: This study was done to analyze the surgical management of peri trochanteric fractures of femur using proximal femoral nail fixation. Good to excellent results were seen in 100% cases of trochanteric fractures and 87.5% cases of sub trochanteric fractures. From this study, we consider that PFN is an excellent implant for the treatment of peri trochanteric fractures of femur.

Keywords :Trochanteric fracture, Sub trochanteric fracture, delayed union, non union, Proximal Femoral Nail.