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Article Type

Original Study

Abstract

Objectives The aim of this work was to evaluate the results of management of 20 adult patients with subtrochanteric femoral fractures using a proximal femoral nail (PFN). Background Fractures of the proximal femur are a big challenge in traumatology. Rapid strides in implant and instrumentations in quest of ideal fixation of subtrochanteric femoral fractures have made various options available. The present study aims to study the role of standard PFN in the management of these fractures. Materials and methods We reviewed the results of 20 consecutive patients who had undergone intramedullary fixation with PFN for traumatic subtrochanteric fractures in our hospital from May 2011 to June 2013, including the follow-up. The average age of the patients was 45 years. Clinical and radiographic analyses were performed during follow-up at 6, 12 weeks, 6 months, and 1 year. Results All patients were clinically assessed according to the Merle d«SQ»Aubigné hip scoring system. Our final results were excellent in 25%, good in 40%, fair in 20%, and poor in 15% of patients. Poor results were seen in three cases. Radiologic assessment included union, malunion, failure of fixation, and implant failure. There was only one case of delayed union and two nonunited cases, with a union rate of 85% at final follow-up. Shortening and varus deformity occurred in two cases but had no effect on the clinical and functional outcome. Failure of fixation occurred in only one case but there were no implant failures. Also there were no intraoperative or postoperative shaft fractures. Conclusion The current study shows that PFN is an evolving safe and successful approach in the treatment of subtrochanteric femoral fractures and can be carried out in a minimally invasive manner.

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