Short Versus Long Proximal Femur Nail for Treatment of Intertrochanteric Femur Fractures

Background: Intertrochanteric fractures are commonly encountered hip fractures worldwide. Nowadays proximal femur nails are increasingly being used to treat intertrochanteric fractures. The current study aimed to evaluate the outcome of short proximal femoral nail compared to long proximal femoral nail for managing intertrochanteric fractures. Methods: This prospective observational study was done at a tertiary hospital from December 2020 to June 2023. Among 63 cases of intertrochanteric femur fractures (AO/OTA type 31A1 and 31A2), 30 were treated with short PFN while the remaining 33 cases were operated with long PFN. Demographic data, various intraoperative parameters, complications, union time and functional outcomes in terms of Harris hip score (HHS) were noted. Student t- test was used to compare continuous data whereas categorical data was compared using Chi-square or Fischer’s exact test (SPSS 20.0 software). Results: The average estimated blood loss (EBL) (83.2 ± 11.1 ml) and duration of surgery (69.0 ±9.4 min) for short PFN group were found to be significantly lesser than the EBL (163.3 ± 21.3 ml) and duration of surgery (86.2 ±11.4 min) for long PFN group. However, similar results were found with regard to age, sex, fracture type, union time, complications and HHS (at 6 months). Conclusions: Use of PFN either short or long for intertrochanteric fractures (31A1 and 31A2) provides good results. Statistically significant lesser operative time and EBL found among the patients treated with short PFN makes it preferable especially in cases of sick and polytrauma patients where shorter operative time with minimal blood loss is desirable.