Abstract: Background: Trochanteric fractures are of intense interest globally, as they are frequently operated. They are fixed commonly either by Dynamic hip screw (DHS) or proximal femoral nail (PFN). The mechanical strength of the nail and less invasive procedure has made the procedure preferable. The different types of nails that are commonly used are, Proximal Femoral Nail (PFN), Proximal Femoral Nail Antirotation2 (PFN A2), Hip fracture nail (HFN) and Halifax nail. The aim of the study was to review intertrochanteric fractures fixation by various types of cephallo medullary nails.
Methods:A retrospective study was conducted at Orthopaedics department of IGIMS, Patna, India. Records of 51 cases operated during 2015 to 2018 which had completed at least one year of follow up and fulfilled the inclusion and exclusion criteria were evaluated. All had been treated using various types of proximal femoral nail for Trochanteric fractures of femur. A radiological assessment was made with serial X-rays.
Results:Most of the patients were between 70-80 years of age. PFN was used in 22, PFNA2 in 24, HFN in 3 and Halifax in only 2 patients. A statistically significant difference (p<0.0001) was noted in the amount of blood loss, duration of surgery and number of C-arm exposures among PFN and PFNA2 groups. However the difference in the functional outcome which was assessed by Harris hip score was not significant, mean score being 81.1 in PFN and 82 in PFNA2 group.
Conclusions: Cephallomedullary nail is a suitable implant for Intertrochanteric femoral fractures. Among them, PFN A2 has slight edge over all others as its instrumentation is easier, operative time is lesser and has lesser c-arm exposure.
