Trochanteric fixation nail (TFN) is a newer device used for the treatment of the intertrochanteric femoral fracture. This study reports the outcome in such fractures treated by using the TFN at northern part of India.
Materials & Methods: In a prospective study from October 2014 to September 2016, we included 64 patients (38 female, 36 male; mean age 59.25years; range 21 to 80 years) who were treated with the TFN for intertrochanteric hip fractures and followed up minimum of six months. According to the AO/OTA classification, there were 14 cases of type 31A1, 42 cases of type 31A2, and 08 cases of type 31A3 fractures. The patients were evaluated clinically (Harris hip score) and radiographically for a minimum period of six months with all complications were recorded.
Results: In our series, most of the patients sustained trauma after simple fall (87.5%) and 12.5% as a result of road traffic accident (RTA).Fractures were classified according to AO/OTA classification, 14 patients had 31-A1 type of fracture, 42 had 31-A2 type of fracture and rest 8 had 31-A3 type of fracture. Mean average delay for surgery was 11.56 days (range 3 to 27 days). Out of 64 patient post-operative radiograph showed near anatomic reduction in 60 patients. We found 6 cases of intraoperative complication in the form of 2 cases of fixation in varus and 4 cases of loss of reduction. We found 8 cases of post-operative complication in which 2 cases of superficial and deep wound infection and 6 cases of varus malunion. No fractures of the femoral shaft, Z-Effect and reverse Z-Effect were noticed. We did not encountered any case of implant failure or avascular necrosis of femoral head. All the patient shows radiological union in our study with mean time of union was 11.02 weeks (12-18 weeks). According to harris hip score, we had good to excellent results in 88%, fair to poor result in 12% of cases.
Conclusions: With proper patient selection, good instrumentation, image intensifier and surgical technique, TFN is a good choice in the management of intertrochanteric fractures leading to high rate of bone union and good functional result with minimal soft tissue damage.