Abstract: Aim: This study is intended to compare the clinical outcome of short proximal femoral nail vs long proximal femoral nail in the management of stable intertrochanteric fractures.
Methods: This is a prospective comparative study of 40 cases of fresh stable intertrochanteric femur fractures admitted to Sanjay Gandhi Institute of Trauma and Orthopedics Bangalore between December 2018 to September 2019. The study population were randomly divided into 2 groups with 20 patients in each group. Group A: The patients who were operated with Short Proximal Femoral Nail. Group B: The patients who were operated with Long Proximal Femoral Nail. Cases were considered according to inclusion and exclusion criteria. Results were evaluated by fracture union on X-ray and Modified Harris hip score.
Results: In our series, majority of the cases in short PFN group were males, i.e 15 (75%) and equal population of males and females in long PFN group, maximum age of 80 years and minimum age of 18 years, most of the patients were between 40 to 60 years. Mean age of 55.6 years in short PFN group and 56.6 in long PFN group, 85% of cases were admitted due to slip and fall. Functional outcome was evaluated by Modified Harris hip score at 3 months,6 months and 1 year follow up. In short PFN group 9 (45%) patients had excellent outcome, 8 (40%) patients had good outcome, 2 (10%) patients had fair outcome, 1 (5%) patient had poor outcome. In long PFN group 8 (40%) patients had excellent outcome, 9 (45%) patients had good outcome, 3 (15%) patients had fair outcome.
Conclusion: Use of Long PFN has advantages over short PFN in terms of the less postoperative complications like peri implant fracture and anterior thigh pain & better functional outcome. The terms of successful outcome include a good understanding of fracture biomechanics, proper patient selection, good preoperative planning and accurate instrumentation.
