“Comparative Study between Long Pfn And Short Pfn in Treatment of Stable Intertrochanteric Fracture Femur”
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 1
Abstract
Background: In elderly population it is most often due to trivial trauma. More than 20000 fractures occur every year and the incidence is expected to double by year 2020.1. In 2003 Takigamiet al2 introduced PFN-A which claimed to have better functional outcome in treating pertrochanteric and subtrochanteric fractures when compared to PFN.Most commonly used intramedullary devices for the management of the proximal femoral fractures are Gamma nail and Short PFN. There are different studies available in literature claiming superiority of Gamma nail 3,4 and Short PFN5,6,7 individually. Among Short PFN and Gamma nail, Short PFN had shown either equal results8or better results9 biomechanically in the management of unstable intertrochanteric fractures. However both implants have higher rate of complications like anterior thigh pain, femoral shaft fractures distal to or around the distal tip of nail 10,11,12,13 and all these lead to higher rate of revision surgery14 in the form of exchange with other fixation device, screw removal or implant removal to achieve union and adequate mobility. Methodology: We have done a prospective study on stable intertrochanteric femur fractures operated with proximal femoral nailing at government general hospital / Siddhartha medical college for a period of 24 months.The study includes patients with stable intertrochanteric fractures admitted from January 2016 to July 2017,Based on inclusion and exclusion criteria. Results:In our series, total number of long PFN cases n = 15,mean age for men is 75.5 , mean age for women is 72 and mean age for long PFN group in our study is 73.7 years.Total number of short PFN cases n = 15, mean age for men is 77.8, mean age for women is 72.8 and mean age for short PFN group in our study is 75.3 years.In the present study, men were more commonly involved. Majority of the patients were male – 9(60%) cases and 6(40%) were females in long PFN group, 10 (66.66%) male and 5 (33.33%) female cases in short PFN groups.Right side was involved in 19 (63.33%) cases and left in 11(36.66%), right side was more commonly involved than left side. In both groups 14 cases (93.3%) affected were due to trivial fall, 1 case (6.66%) was due to RTA. Trivial fall was the most common mode of injury.Mean weeks for radiological union in long pfn group is 13.3 weeks.Mean weeks for radiological union in short pfn group is 14.4 weeks. In our study, according to Harris Hip Score15 (modified), good results are seen in 66.66 % cases of intertrochanteric fractures operated using long PFN and 33.33% cases of intertrochanteric fractures operated using short PFN. Conclusion: In our results it was evident that the use of Long PFN has advantages over short PFN in terms of the less postoperative complications, less mean time of union & better lower extremity functional scores.Most of the complications of proximal femoral nailing are surgeon and instruments related which can be cut down by proper patient selection, good preoperative planning and preoperative good reduction before entry and correct length of the screws.
Authors and Affiliations
Dr. C. Shyamkumar, Dr. A. Srinivasa rao, Dr. D. Venkateswara Rao, Dr J. Vikramkumar
Keywords
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- EP ID EP264237
- DOI 10.9790/0853-1701132329
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