Prospective study of proximal femoral nail in management of trochanteric and subtrochanteric fractures of femur

Aims: 1) Evaluation of Effectiveness and strength of Proximal Femoral nail in management of Trochantric and Sub-Trochantric Fractures. 2) Early mobilization and functional recovery of patient Objectives: 1) Stable Internal Fixation designed to fulfill biomechanical demands. 2) Toassist & enhance fracture healing. Method: It is a prospective study carried out from 2008 to 2014 in the Dept. Of Orthopaedics, RMC, Loni. Total 39 cases were treated. Boyd and Griffins classification is used. Majority of cases were from of 5 th -8 th decade of life. Stability of fractures is judged by presence of posterior-medial femoral cortex integrity. In all cases standard 25 mm PFN of 135 0 /130 0 were used. Results: After average follow-up of one year good to Excellent Hip range of motion was seen in 36 cases. All cases showed fracture union. No Z effect seen in any case. Except 2 cases which showed Reverse z effect and in 1 case nail breakage was seen without affecting functional abilities. Average fracture union time was 16 weeks. Conclusion: Proximal Femoral Nail is biomechanically sound fixation, minimally invasive which permits early mobilization, prevents excessive varus collapse at fracture site, produces less stress riser effect below tip of nail. But it also appears from this series that Indications of fixation are limited, excessive Lateral cortex comminution may limit its use. Still Proximal femoral nail is to be time tested to call it as best treatment modality for inter torchanteric & subtrochanteric fractures.