Treatment of Unstable Trochanteric / Subtrocanteric Fractures with PFN, First Cases in University Hospital of Trauma & American Hospital. Results and Complications.

Aims and objectives: This study was done to evaluate the functional and radiographic outcome of PFN in treatment of proximal femoral fracture and more common technical, mechanical complications and intraoperative difficulties during the implant implementation. Materials & Methods: We conducted a retrospective study with ten cases of proximal femoral fractures treated between September 2017 and September 2018, which were accepted at the Department of Orthopedics, the University Hospital of Trauma and the American Hospital in Tirana. Fractures are classified according to classification AO and Boyd-Griffin. The age range of patients taking the study was 20-90 years. Ten cases were followed at regular intervals and the final assessment was made at the end of the 6 month period. In the result, functional clinical assessment according to Harris hip score was done . Results: In our study,mean age was 66 y.o, 7 male and 3 females. Mean of hospitalization time 6 days, mean operation time 120 min. In our study at 6 months follow up, union was achieved in 9 cases, open reduction was performed in 3 cases (10 cases). Technical and mechanical complications were noted in one case. Reoperation rate was 10 % (one case). According Harris hip scoring system excellent results were seen 40   % of cases (4 cases), good results in 50 % cases (5 cases),  and poor results in 10% cases (1 case). Conclusions: In our study, in spite of low experience in proximal femoral nailing in cases with unstable trochanteric / subtrocanteric fractures, it was found that PFN is an attractive implant and suitable for proximal femoral fractures and its use in unstable trochanteric / subtrocanteric fractures is very encouraging. This study has also shown that this device can safely be used by an average surgeon to handle common but sometimes tough fractures. Operation is technically not difficult, but gradual learning and great patience is needed to make this method really minimal invasive.