Introduction: Unstable peritrochanteric fractures of the femur are among the most challenging injuries in orthopaedic trauma, especially in the elderly with osteoporotic bone. The proximal femoral nail (PFN), a cephalomedullary device, offers potential biomechanical and clinical advantages. Objectives: To assess (1) the functional outcome of PFN in unstable peritrochanteric femoral fractures using the Harris hip score (HHS); (2) the radiological outcome using the radiographic union score for hip (RUSH); and (3) complications associated with PFN fixation. Materials and Methods: A prospective observational study was conducted at the Department of Orthopaedics, Gajra Raja Medical College and J.A. Group of Hospitals, Gwalior (M.P.), from September 2022 to June 2024. A total of 74 patients with unstable peritrochanteric fractures (Arbeitsgemeinschaft für osteosynthesefragen AO 31A2.2-A3.3) were operated on using PFN. Functional outcome (HHS) and radiological outcome (RUSH) were evaluated at 6 weeks, 3 months, and 6 months postoperatively. Statistical analysis was performed using Statistical Package for the Social Sciences v26 with paired t-tests, considering P 18) was seen in 6.7% at 6 weeks, 54.1% at 3 months, and 98.6% at 6 months. Complications included superficial infection (4.05%), screw back-out (1.3%), reverse Z-effect (1.3%), and non-union (1.3%). Conclusion: PFN provides stable fixation, early rehabilitation, and high union rates in unstable peritrochanteric fractures. Its minimal soft-tissue dissection and superior biomechanical profile make it a preferred implant, especially in osteoporotic bone. Keywords: Femur intertrochanteric fracture, Harris hip score, proximal femoral nail, rush, unstable peritrochanteric fracture.
Shira et al. (Thu,) studied this question.
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