Evaluation of the Clinical and Functional Outcome of the Patients with Intertrochanteric Fractures Treated with a Proximal Femoral Nail in Northern Tanzania

Background: Hip fracture is common and it is escalating, lead to one-fifth of the orthopedic operative work and it is associated with significant morbidity, mortality and leads to a burden to the health care system while over half of the patient does not returns to premorbid mobility status. The goal of the treatment is to attain anatomical reduction with internal fixation to facilitate rapid mobilization of the patient and prevent morbidity and mortality. This study intends to establish the clinical and functional outcome of the patients with intertrochanteric fractures treated with a proximal femoral nail. Method: This was a hospital-based cross-sectional study conducted at KCMC from January 2018 to November 2019 involving a total of 92 patients with intertrochanteric fractures who were called and evaluated for clinical and functional outcome using Harris score after treatment thereafter data was analyzed. Result: This study included a total of 92 study participants, 63.1% were males with a mean age of 55years, the majority come from rural areas 58.7% and had a longer hospital stay of > 14days 51.4%, simple fall was the common cause of injury 41.3%, while the majority had excellent hip status 42.4%, good hip status was 28.5%, fair hip status was 10.8%. In this study, 76.1% had appropriate implant position, 18.5% had screw cut out, 81.5 had fracture union, 82.6% had proper fracture reduction, apex distance was less than 25 mm in 77.2% and 81.5% had 120 – 135 degrees diaphyseal angle, the main leading complication 9.8%, followed by reoperation 6.5%, 9.8% had fascia late pain, 8.7% had acetabula penetration//irritation, death was 4.3%, periprosthetic was fracture 3.3% and, 6.50% had limb discrepancy shortening. Conclusion: Therefore, the proximal femoral nail is a better method of intertrochanteric fracture fixation with a good both clinic and function outcome and minimal complication after the operation.