A Study of Functional Outcome of Proximal Femur Fractures Managed by Proximal Femoral Nailing

Introduction: Extracapsular proximal femur fractures include trochanteric and subtrochanteric fractures are seen in both young, adults and elderly population following trauma or pathological cause. With trial and evolution of different types of implants for surgical management, it was found that intramedullary implants were best suited for unstable. This study aims to evaluate functional and radiological outcome of extracapsular proximal femur fractures managed by proximal femur nail. Objectives: To analyze the functional radiological outcome of unstable proximal femur fractures managed with proximal femur nailing by modified Harris hip score and by pre - operative, intra - operative, post - operative serial radiographs. Methods: This prospective study includes 40 patients with unstable extracapsular femur fractures treated with proximal femur nail. The functional outcome of fixation is assessed using modified Harris hip score for a duration of 6 months and the radiological outcome is assessed using serial radiographs. Results: In this study the mean modified Harris hip score at 3 months is 80.55 and at 6 months is 85.35 which is GOOD functional outcome according to the scoring system used. Only 1.25% patients had poor outcome. The average time of union observed is 21.57 weeks. Conclusions: From this study, we consider that proximal femoral nail as a reliable implant for the treatment of unstable extracapsular proximal femur fractures. This implant also gives good functional outcome in intertrochanteric and subtrochanteric fractures. Even though the learning curve of this procedure is steep with proper patient selection, good instruments, image intensifier and surgical technique, PFN remains the implant of choice in the management of extracapsular proximal femur fractures. Patients treated with PFN are typically allowed early mobilization and weight - bearing, leading to a decrease in complications such as bedsores, uremia, and hypostatic pneumonia.