Evaluation of Results in Intramedullary Fixation of Subtrochanteric Fracture of Femur With Proximal Femoral Nailing (Ao Type of Design)

BACKGROUNDAmong the femoral shaft injuries, upper femoral fractures present a peculiar problem of securing effective neutralization of deforming forces.The mechanical stresses at this level are very high, as they occur at the junction between the trabecular and cortical zone and also because of the deforming forces due to peculiar muscle insertion to the proximal and distal fragments.The present study was conducted to assess the utility and effectiveness of Proximal Femoral Nail evolved by AO-ASIF in 1997, for various types of upper femoral fractures. MATERIAL AND METHODThe present study consists of the patients admitted to Orthopaedic Units of KIMS Hospital, between June 2012 and July 2014; 1267 fracture cases were treated in Department of Orthopaedics, Konaseema Institute of Medical Sciences, Amalapuram, during this period.Of these 264 patients were admitted for femoral fractures.Of the 264 femoral fractures, 18 patients above the age of 20 years with subtrochanteric fractures were included in this study. RESULTReduction was good in 72.2% (13) of the cases.Acceptable reduction was achieved in 3 (16.6%)patients.Poor reduction was noted in 2 (11.1%) patients.One of them were of elderly age group and had poor outcome at final follow-up. SUMMARY AND CONCLUSIONFrom this sample study, we conclude that Proximal Femoral Nail is a good implant for the treatment of subtrochanteric fractures of femur provided optimal reduction of the fracture and good positioning of the nail and screws are achieved.