Mallam Kiran Kumar, Pramod Jain
BACKGROUND The purpose of this meta-analysis was to find out whether the proximal femoral nail was better implant for the treatment of trochanteric fractures with respect to operation time, blood transfusion, hospital stay, wound complications, number of reoperation and union rate. MATERIALS AND METHODS A prospective study was done from January 2015 to June 2017, which included 74 patients aged over 60 years with intertrochanteric fractures classified accordingly ‘Boyd & Griffin” system, who underwent osteosynthesis using PFN. The results data were assessed clinically using Harris Hip Score and radiological findings were compared at 3, 6, 12 and 18 months post-operatively. The mean follow-up period was 18.5 months (range 6-24 months). RESULTS The mean operation time was 40.5 minutes (range 22-118 min.) and the mean blood loss was 225 ml (range 150-450 ml). Union was obtained in all cases. Reduction was poor in 2 (2.7%), acceptable in 25 (33.8%) and good in 47 cases (63.5%). Post-operative complications included secondary varus (n=4, 5.4%), Z effect (n=5, 6.75%) reverse Z effect (n=2, 2 .7%), shortening (mean 8.2 mm, n=12, 16.2%), and cut-out of neck screw (n=3, 4.05%). The mean duration of fracture union was seen in 16-20 weeks (n=65, 87.75%). The mean Harris Hip Score was 77.6 and observed in category excellent (n=13, 17.55%), good (n=21, 28.35%), fair (n=19, 25.65%) and poor (n= 4, 4.05%). CONCLUSION Due to advantages of high union rate, early mobilization and short operative time PFN osteosynthesis is the method of choice for surgical treatment of intertrochanteric femoral fractures in geriatric population.
