Abstract: Background & Aim:
Intertrochanteric fractures in adults are common fractures & osteoporosis leads to significant complications associated with the fractures, prolonged immobilization, high morbidity & mortality. Hence the aim of the study was to see the effectiveness of Short Intramedullary Proximal Femoral Nail in these types of fractures.
Material & Methods: In the current study total 30 patients were followed who presented at the tertiary level centre for Orthopaedics. Average age of the study group patients was 62 years. The patients selected between the duration total six months & were followed up for total 12 months. Patients regularly followed till radiological union & evaluated with harris hip score for functional outcome. The main focus given in the proper technical operative steps & strict guarded mobilization.
Results: Partial weight bearing allowed in 20% of patients at 4 weeks post operatively & in 80% of patients after 4 weeks. Average radiological union time was 2.5 months.73.33% fractures unite in between 8-16 weeks duration. Three patients had some varus fracture union.One patient had upper screw cutout from the head & later on superior screw removed after union. One patient had avascular necrosis of head of the femur early changes (Ficat Arlet stage 1) at the end of 6 month. One patient has wound gaping with superficial skin & subcutaneous infection. One patient had nonunion implant failure & revision surgery performed.80% of patients had good to excellent harris hip score. Average operative time was 55 minutes.
Conclusion: The short proximal femoral nail allows surgeon for easier insertion of the nail (only proximal reaming) & Minimal blood loss all leads to less complications. Good knowledge & application of proper surgical technique intraoperatively is important. Careful patient & fracture selection & early guarded vigilant mobilization are crucial factors for good management of intertrochanteric fractures.