Abstract: Background: The incidence of fractures of the peri trochanteric fractures is increasing since the general life expectancy of the population and related osteoporosis has increased significantly during the past few decades. They are second most common fractures related to osteoporosis, by the year 2050, intertrochanteric fractures will be ones taking a major share of them. The mechanism of action of TFN is controlled collapse at the fracture site on weight bearing leading to compression at the fracture. It has been noticed complications such as implant failure, screw back-out, protrusion of implant over the tip of the greater trochanter causing impingement, the z effect involves lateral migration of inferior head screw and medial migration of superior head screw and opposite is reverse z effect. We have hereby conducted the study to evaluate the functional outcomes and complications of trochanteric femoral nail in intertrochanteric femur fractures based on clinical and radiological findings.
Materials and Methods: A prospective, single blinded, randomized control trial with 43 cases, out of which 24 were males and 19 were females was conducted. The postoperative evaluation was done both clinically and radiologically. Out of the 43 cases, follow up at outpatient level at regular intervals at 6wks, 3months, and 6months for serial clinical and radiological evaluation was done. At each follow up, patients were evaluated clinically using the Modified Harris Hip Score and radiologically with appropriate X-rays. The intraoperative blood loss, duration of surgery, intra operative complications, post-operative complication, duration of hospital stay were studied.
Results: Results were evaluated by modified Harris hip score in our series we had 30.2% excellent, 48.8% good, 16.3 % fair and 4.7% poor results. The nail protrusion height was >5 in 74.4% of the patient.
Conclusion: Trochanteric femoral nail can be considered the most judicious and rational method of treating intertrochanteric fractures, but it we recommend a modification to the Trochanteric femoral nail that would further shorten the proximal nail end 5–10 mm for the Indian population, so as to avoid soft tissue irritation on lateral trochanter.
