Outcomes of proximal femoral nailing in adults treated for subtrochanteric femur fractures.

Abstract

Objective: To assess the functional & radiological outcomes of proximal femoral nailing (PFN) in treating subtrochanteric femur fractures in adults. Study Design: Prospective study. Setting: Afridi Medical centre & Teaching Hospital Peshawar Pakistan. Period: Jan 2022 to October 2024. Methods: Patients of age 20 to 80 years admitted due to acute subtrochanteric (ST) femur fractures were included in the study. Open & pathological ST fractures were excluded. The Harris Hip Score was utilised to assess the postoperative outcomes. In all the cases, patients were put on immobilization preoperatively followed by closed reduction & fixation with PFN under spinal anaesthesia. Both radiological outcome by examining radiological union at fracture site and functional outcome through determining Harris Hip Score were determined at 4 months postoperatively. Microsoft excel was used for data analysis. Results: Radiological union was observed in the patients as early as 14 weeks postoperatively followed by radiological union in all the patients at 16th week postoperatively and no non-union case was observed in our study. Out of all 91 cases only 5 cases were having mild surgical site infection which was managed accordingly the sterile dressing and oral antibi.=otics. The overall Harris hip score to be 90.75±6.85 in our study. Among total 91 patients 68 (74.72%) patients fall in excellent, 15 (16.48%) in good, 6 (6.6%) in fair while 2 (2.2%) in poor categories of Harris hip score. Conclusion: PFN is an effective implant for treating femoral subtrochanteric fractures. The advantages include reduced surgical exposure, increased stability, and early mobilisation. Because it allows for early and stable mobilization, PFN may be superior for treating subtrochanteric fractures in the elderly as well.