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Abstract
FUNCTIONAL OUTCOME OF PROXIMAL FEMORAL NAILING FOR UNSTABLE INTERTROCHANTERIC FEMORAL FRACTURE IN PATIENT MORE THAN 60 YEARS OLD
Dr. Rabah Abdulla AL- Ebadi F.I.C.M.S (Ortho)*, Dr. Wisam Abdalsalam Younis M.B.Ch.B. and Ahmed Sedeeq Majeed. C.A.B.M.S.
ABSTRACT
Background: Hip fracture include intertrochanteric fracture due to fall are one of the most common orthopedic problem in elderly, it is account about half of the all-hip fracture in elderly. The proximal femoral nail (PFN) is an intramedullary device used for the treatment of unstable sub- , intra-, per trochanteric femoral fractures. Objective: The aim of the study is to assess the functional outcomes of proximal femoral nailing for unstable intertrochanteric femoral fracture in-patient more than sixty years old. Patients and Method: The study is prospective interventional in Al-Mosul teaching hospital. A total seventy patients above sixty years with isolated closed unstable intertrochanteric fracture of femur depended on Evans classification were treated by PFN during the period from the January 2021 till the July 2022 with follow-up for functional outcome measured at three and six months using Harris Hip Score. Results: Of the seventy patients 44 (62.85%) females, 26 (37.15%) males. Forty-six of the patients had right side and twenty-four left side. Most of the patients sustained injury after fall from standing height, which are sixty (85%) patients, while only ten (15%) patients RTA. Most of the patients were between 71-80 years (51%). Mean operative time 90 minutes. Two patients developed superficial infection at the site of operation, two patients had lateral migration of the neck screw, eight patients had varus collapse of the fracture site and six patients had abductor weakness. On follow up, we lost the follow up of two patients. The functional outcome at the end of 6 months was poor for two (2.9%) patient, fair for six (8.8%) and good for 20 (29.4 %) patients and excellent for 40 (58.8%) patients. Mean HHS at the end of 6 month was 88. Conclusion: For unstable intertrochanteric fractures, the PFN has significantly giving the best outcomes in early restoration of the walking ability and needs short operative time as well as smaller incision. PFN gives stable fixation and early post-operative mobilization and good fracture healing.
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