Vol. 11, Issue 3 (2025)

Background: Intertrochanteric fractures are among the most common fragility fractures in elderly patients, often associated with significant morbidity and functional impairment. Proximal femoral nailing (PFN) has emerged as a preferred fixation technique due to its biomechanical stability and potential for early mobilization.

Aim of the study: To evaluate the effectiveness of proximal femoral nailing in elderly patients with intertrochanteric fractures, focusing on perioperative details, fracture healing, functional recovery, and complication profile.

Methods: A prospective observational study was conducted at BSMMU, Dhaka, between September 2022 and September 2024, involving 18 elderly patients with intertrochanteric fractures managed with PFN. Demographic data, comorbidities, fracture type, perioperative parameters, functional outcomes (Harris Hip Score, Visual Analog Scale), and complications were recorded and analyzed.

Result: The mean age was 67.17±10.99 years, with a slight female predominance (55.6%). Osteoporosis was present in 55.6% of patients. The average operative time was 63.9±8.8 minutes with mean intraoperative blood loss of 95±56.7 ml. Radiological union was achieved at 14.5±1.6 weeks, and full weight-bearing at 12.3±2.1 weeks. Functional outcomes improved significantly, with mean Harris Hip Score increasing from 47.6 at one month to 88.8 at 12 months, and mean VAS decreasing from 7.5 preoperatively to 0.7 at 12 months. Independent ambulation was achieved in 61.1% of patients at six months. Complications were minimal, with superficial infection, screw cut-out, and thigh pain observed in one case each (5.6%).

Conclusion: Proximal femoral nailing is an effective and reliable treatment for intertrochanteric fractures in elderly patients, offering early mobilization, satisfactory fracture union, and favorable functional outcomes with low complication rates.