DOI: 10.36347/sjams.2022.v10i04.036

Pages: 645-650

Background: Intertrochanteric femoral fractures are common fractures representing 45% of hip fractures. The best treatment option is still a matter of debate. Proximal Femoral Nail (PFN), a modern intramedullary implant offers several advantages. This study is to evaluate the outcome of fixation of unstable intertrochanteric fractures with Proximal Femoral Nail (PFN) in our setting. Material & Method: A prospective short-term interventional study was conducted at Dhaka Medical College Hospital, Dhaka, from January 2020 to December 2021. Patients with unstable intertrochanteric fractures meeting the selection criteria were the study population. A total of 38 patients were included in the study. All cases were treated with PFN and were evaluated by Harris Hip Score (HHS). Results: The mean age was 62.6±14.9 years with a female predominance (55.3%). The main cause of injury was fall on a slippery ground (57.9%). The most occurred fracture was Kyle type III (78.9%, n=30). The mean duration of injury to operation was 11.7±4.7 days. The mean duration of follow-up was 21.9±1.6 weeks, ranging from 20 weeks to 24 weeks. Superficial wound infection was the most common complication, found in 3(7.9%) cases. Mean radiological union time was 12.55± 2.31 weeks. Maximum Limb Length Discrepancy (LLD) was 1 cm in 7(18.4%) and in 29(76.4%) cases there was 0 cm of LLD. The mean Hip score was 87.0±16.1. Finally, evaluation of 38 cases, 20(52.6%) were excellent, 12 (31.6%) were good, 5 (13.2%) were fair and the rest 1 (2.6%) were poor according to the Harris Hip Scoring System. Conclusion: Proximal Femoral Nail (PFN) is an ideal implant for the treatment of the unstable intertrochanteric fracture. It is a simple, easy, minimally invasive, reliable, and effective method with shorter operative time, lesser blood loss, and reasonable time to bone healing with early mobilization of the patients.