Proximal femoral nail for treatment of Unstable Trochanteric fractures, Review of Results in 60 cases

Introduction :To review the outcome of 60 patients treated with a proximal femoral nail (PFN) for Unstable trochanteric fractures from Jan 2010 to Dec 2011. Methods: 27 men and 33 women aged 28 to 90 (mean, 63) years with Unstable trochanteric fractures underwent PFN fixation using an cephallo-medullary nail, a lag screw, and a hip pin & Interlocking Bolts. Fractures were classified according to the AO system; the most common fracture type was A3 (n=35), followed by A2 (n=25) with Left sided( 65%) Predominance. 15(25%) Fractures required to be openly reduced & fixed. All Fractures were satisfactorily Fixed using standard long or Short PFN depending on Fracture architecture & results were analysed. Average follow-up was for 15 months. Average Operating time was 90 min with average Blood Loss of 150 cc . Results: 90% of lag screws were optimally placed with well reduced fracture. 58(95%) united within average of 15 weeks(1218 weeks). Fractures in Males united slightly earlier than the Fractures In Females .2 cases had breakage of Implants & hence Non Union occurred. Average shortening was 2cms & No External Rotation Deformities were witnessed. 54 cases (90%) had good to Excellent results, 6 cases (10%) had poor results ,either Infection (3) , Breakage of Implants (2) & 1 had gap Nonunion. Conclusion: PFN is an useful & reliable Implant for the treatment of Unstable trochanteric Fractures at any age