Abstract

Background: Proximal femoral fractures are one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to low-energy trauma and in young adults due to high velocity trauma. The incidence of these fractures is rising because of increasing number of senior citizens with osteoporosis. The problems associated with proximal femoral fractures are due to substantial morbidity and mortality, malunion, implant failure and associated medical conditions. Therefore, this has led to the development of intramedullary devices in the management of proximal femoral fractures. Objective: To analyse the efficacy and functional outcome of proximal femoral nail in proximal femoral fractures.

Materials and methods: A prospective cohort study with 153 adult patients with proximal femoral fractures were treated with proximal femoral nailing in JJM Medical College, Davangere between 2013 to 2018. The fractures included in the study were trochanteric and subtrochanteric fractures were classified according to Boyd & Griffin and Seinsheimer classification respectively. All the cases were followed at regular intervals as per our study protocol. The functional outcome was assessed with Harris Hip Score.

Results: In the present study, 88 trochanteric fractures and 65 subtrochanteric fractures underwent surgical fixation with proximal femoral nail. The functional results assessed by Harris Hip score showed excellent in 65 cases (42.48%), good in 46 cases (30.07%), fair in 27 cases (17.64%) and poor in 15 cases (9.80%). The complications occurred in the study were tracked and were treated by appropriate methods.

Conclusion: We conclude that the proximal femoral nail is a reliable implant for proximal femoral fractures, leading to high rate of bone union restoring the anatomical alignment and reduced chance of implant failure or deformities. Intramedullary fixation has biological and biomechanical advantages with decreased the morbidity and improved functional quality of life.

Keywords: Proximal femoral fractures; Proximal femoral nail; Trochanteric fractures; Subtrochanteric fractures