Vol. 10, Issue 4 (2024)

Introduction: The subtrochanteric region is usually exposed to high stresses during routine activities. Axial loading forces through the hip joint create a large moment arm, with significant lateral tensile stresses and medial compressive loads. In addition to the bending forces, muscle forces at the hip also create torsional effects that lead to significant rotational shear forces.
Objective: To evaluate the results of internal fixation of subtrochanteric fractures of the femur with proximal femoral nail.
Methods: This was a prospective study carried out at Department of Orthopedic Surgery, BSMMU, Dhaka, Bangladesh from January to June 2023 on 60 patients who had suffered subtrochanteric fracture and were subsequently treated with a proximal femoral nail (PFN). Proximal femoral nail was inserted through the tip of greater trochanter. All patients were followed up for a period of one year; at an interval of 3 months and during each follow-up visit for the functional outcome by modified Harris Hip Score, was assessed in the form of walking, squatting, sitting and rising from chair.
Results: Total 60 cases with proximal femur Subtrochanteric fractures. In our study, the average age was 43.33 years, with a maximum age of 65 years and a minimum age of 18 years. The majority of the patients were males, with 44 (73.3%) of the 60 patients being males and 16 (26.7%) being females. Modified Harris hip score was used for the evaluation of results in our study which showed excellent result in 42 patients (70%), good results in 6 cases (10%), fair results in 6 patient (10%) and poor results in 6 cases (10%). The mean Harris hip score in our study was 90.6. 
Conclusion: PFN is an intramedullary load-sharing implant. Reduction and treatment of subtrochanteric fractures are a challenge in traumatology. Proximal total femoral nailing with proximal and distal locking appears to be a satisfactory implant for the treatment of subtrochanteric femoral fractures.