Peritrochanteric fractures are devastating injuries that most commonly affect the elderly and also in young, have a tremendous impact on both the health care system and society in general. Peritrochanteric fractures mainly comprise of fractures of trochanter and subtrochanteric region. The goal of treatment of an intertrochanteric fracture is restoration of the patient to his or her pre-injury status at the earliest possible time. Internal fixations of these fractures are recommended to increase patient comfort, facilitate nursing care, decrease hospitalization and reduce complications of prolonged recumbency.
Material and methods: A prospective comparative study was carried out in orthopaedic department at tertiary care centre. Total 60 patients were enrolled in the study which were randomized into 2 groups. Group I (n=30) patients were operated with Long PFN and Group II (n=30) patients were operated with Short PFN. Patient were evaluated using Hip Harris score and p value of < 0.5 was considered significant.
Results: The mean age in Long PFN Group was 49.63±13.82 years and 47.77±14.83 years for short PFN groups. Road Traffic Accident was observed to be the main cause of fracture in both the groups (70% and 66.7% respectively). Mean blood loss 87.17±27.84 ml in Long PFN group and 98.67±47.32 ml in short PFN group. The mean operative time was 75.5±19.62 minutes in long PFN group and 73±19.01 minutes for Short PFN group. The mean time for fracture union was 3.30±1.82 months. There was no significant difference between the groups. There was 1 complication of non-union in Long PFN group. In Short PFN group there were 2 cases of deep infection and 1 case each of non-union, bed sore and shortening. There was comparable improvement in both the groups as per Harris Hip Score but the difference was statistically not significant.
Conclusion: Both the long and short intramedullary nails are the optional internal fixation choices for Peritrochanteric and subtrochanteric Factures. But the long nail could avoid the refracture of femur and reduced postoperative hip pain.