A prospective study of clinico-radiological outcome assessment in intertrochanteric fracture treated with proximal femoral nail

Purpose: Intertrochanteric fractures of proximal femur are commonly encountered in elderly individuals due to porotic and weak bones. Surgical management such as dynamic hip screw, gamma nail, condylar plates are routinely used but the outcome is very poor. In this backdrop, the present study was carried out to evaluate the clinical and radiological outcome of Proximal Femoral Nail (PFN) in the treatment of intertrochanteric fractures.

Methods: A prospective study was carried on 45 patients with stable intertrochanteric fractures visiting our hospital for a period of two years. The patients were surgical treated PFN and subsequent follow was done upto a period of 3 months. The clinical and functional outcome was analyzed using Tip Apex Distance (TAD), Cleveland Index and Palmer and Parker score.

Results: The mean surgical time was 62.56 ± 8.02 minutes. Out of 45 patient 40 had fracture union and 1 patient had infection and non-union and 1 patient had delayed union. Screw cut out was observed in 5 patients and 1 patient had screw migration to joint. The mean Cleveland index was 6.04 ± 1.05 and TAD was 23.8 ± 2.16 mm at different post-operative periods. Further there was a significant improvement in Palmer and Parker score from 6 weeks to 3 months post-operative (p=0.000).

Conclusion: Proximal femoral is a safe and effective implant for the intertrochanteric fracture fixation in elderly population. Further, the intraoperative blood loss is very minimal with less complication, good union and lesser surgical time.