Optimal fracture site compression of trochanteric region fracture managed with proximal femoral nailing at the time of surgery: Analysis of clinico-radiological and functional outcome

Objectives: Proximal Femoral Nail (PFN) with dual cephalic screw configuration is now widely used for management of trochanteric region fracture. Good fracture reduction and intraoperative achievement optimal site compression are very important surgical steps proximal femoral nailing. There limited information available in literature regarding while fixation by PFN screws (lag anti-rotation screws). We practicing a technique alternate tightening lag PFN. Aim this study to evaluate the clinico-radiological functional outcome adequate achieved method. Materials Methods: Total 47 patients, who underwent fractures during September 2017 October 2019 12 months follow up period, were included prospective study. Fractures classified according AO/OTA system; most common type 31A2 (n = 28), followed 31A1 18) 31A3 1). At time fixation, was performed combination two - 1) giving firm manual pressure towards medial direction help Jig after nail insertion into medullary canal, maintaining till both 2) final sitting achieved. Clinical radiological parameters including quality reduction, tip-apex distance (TAD), lateral slide screw, length as well complications measured. Functional assessed using Harris Hip Score (HHS). Results: 89.4% cases. Mean TAD AP (anteroposterior) 11.6 mm, mean LAT (lateral) 11.1 mm 22.7 mm. Overall 3.2 it more unstable 31A2fracture. The HHS at postoperatively excellent 20 (42.6%), good 16 (34.0%), fair 5 (10.6%), poor 6 patients (12.8%). Conclusion: Intraoperative shows results low incidence complications.