Effect of proximal femur nail anti-rotation on unstable intertrochanteric fractures: A prospective observational study

Objective: To assess the effect of proximal femur nail anti-rotation on the functional and radiological outcome of unstable intertrochanteric fractures.Methods: This prospective observational study was conducted in the orthopedic department of a tertiary care hospital. Altogether 86 patients with unstable intertrochanteric fractures treated with proximal femur nail anti-rotation between January 2010 and January 2015 were included. Patients were followed in the outpatient clinic at regular intervals after discharge to assess the radiological union of fractures and complications. The functional outcomes were evaluated after 2 years by Harris hip score.Results: All patients achieved a radiological union of fractures after a mean duration of 24.6 weeks. The follow up showed 23 complications (systemic and local). Eight patients developed urinary tract infections, and three patients developed chest infections, two patients had screw cut-out, one patient had knee stiffness, one patient developed superficial surgical site infection, and four patients developed varus collapse and shortening subsequently. The two year follow up showed that 69 (80.2%) patients had an excellent and good functional outcome according to Harris hip score.Conclusions: With lower complication rates, proximal femur nail is a valid and reasonable option especially in treating unstable intertrochanteric fractures.