Clinical and Radiological Outcomes of Intertrochanteric Femur Fractures Treated With the Trochanteric Fixation Nail: A Prospective Observational Study From a Tertiary Care Centre in South India

Introduction Intertrochanteric fractures of the proximal femur are common among elderly individuals and contribute substantially to morbidity and mortality. The trochanteric fixation nail (TFN) was designed to enhance biomechanical stability, allow early mobilisation, and minimise implant-related complications compared with extramedullary devices. However, data from Indian settings encompassing both stable and unstable intertrochanteric fractures remain limited. This study prospectively evaluated the clinical and radiological outcomes of TFN fixation across this spectrum in a tertiary care centre in South India. Methods A prospective observational study was conducted between January 2023 and June 2024 at a tertiary teaching hospital. Thirty adult patients with intertrochanteric fractures classified as Boyd and Griffin types I-IV underwent fixation with TFN. Data were collected using a pre-tested, semi-structured proforma encompassing operative details, radiological union, and functional outcomes assessed by the Harris Hip Score (HHS). Follow-up evaluations were performed at 1, 3, 6, and 12 months. Statistical analyses included repeated-measures analysis of variance (ANOVA) and Chi-square tests. Results Among 30 patients (mean age 64.2 ± 9.8 years; 17 males, 56.7%; 13 females, 43.3%), type II fractures were most common (16 patients, 53.3%). The mean operative time was 80 ± 18 minutes, and the mean intraoperative blood loss was 110 ± 25 mL. All fractures (30 patients, 100%) achieved union, with a mean radiological union time of 11.2 ± 1.8 weeks. Functional recovery improved significantly over time, with mean HHS increasing from 48.2 ± 6.4 at one month to 92.8 ± 5.2 at 12 months (F (3,87) = 64.3, p < 0.001). Complications were minimal, limited to two cases of superficial infection (two patients, 6.7%), with no implant failures or non-union. Conclusion TFN fixation for intertrochanteric fractures demonstrated a 100% union rate, excellent functional recovery, and a low complication profile. These findings support TFN as an effective and reliable fixation method for intertrochanteric fractures in Indian tertiary-care settings.