Study on functional outcome of subtrochanteric femur fractures treated with proximal femoral nail

Abstract

Introduction: The difficult nature of treating subtrochanteric fracture stems in part from the fact that this injury pattern is anatomically distinct from other proximal femoral peritrochanteric fractures and also from the femoral shaft fractures. The present study was made attempt to evaluate the functional outcome of subtrochanteric femur fractures treated with proximal femoral nail. Materials and Methods: The present study conducted on subtrochanteric femur fracture cases admitted in GSL medical college and general hospital, Rajahmundry during December 2013 to July 2015. Ethical Committee Clearance was obtained before beginning of the study. All patients were maintained on traction before surgery. All surgeries were done under spinal or epidural anaesthesia, low molecular weight heparin prophylaxis is given subcutaneously for the high risk patients during the hospitalization. Result: Majority of the cases were due to high energy trauma of Road traffic Accidents involving relatively younger patients. The operating time for 72% cases was between 1 to 2 hours. Operating time decreased with increasing familiarity of the implant system. The average length of Hospital stay was 17.6 days. At the end of five months, all except three patients could mobilise independently without any aid. According to harris hip score, 3 (12%) patients had excellent outcome, 18 (72%) patients had good outcome and 4 (16%) patients had fair outcome. Conclusion: In conclusion, Proximal femoral nail is a good implant for subtrochanteric fracture of the femur. The advantages are minimal exposure (closed technique), better stability and early mobilisation. Fractures united in all cases and postoperative functional outcome was satisfactory.