“FUNCTIONAL OUTCOME OF FRACTURE OF INTERTROCHANTERIC FEMUR IN OLDER PATIENT WITH PROXIMAL FEMORAL NAIL(PFN) A2 AT PRAVARA RURAL HOSPITAL , LONI”

Registration ID: IJNRD_226859

Published ID: IJNRD2408365

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Dr Dhairya LALCHETA , Dr Kailash Ghorpade , Dr Prafulla Herode , Dr Ashish Somani, Dr Chaitanya Khanolkar

Fracture, intertrochanteric femur, PFN A-II, osteoporosis, Functional outcome

ABSTRACT Background: Intertrochanteric femoral fractures are of commonest over worldwide. They are the most frequently operated fracture type in old age. Though predominately associated with low-energy older age patients, high-energy trauma in young patients can result in similar patterns of fracture. A higher predisposition towards Intertrochanteric fracture is seen in females than males due to osteoporosis(1). Low-energy falls from a standing height stands accountable for approximately 90% of the hip fractures sustained in patients over the age of 50 years, with a higher incidence in females. High- energy hip fracture is relatively rare, and is more common in males under the age of 40 years. Proximal femur nail antirotaion - II aka PFNA-II is one of the most recent techniques used in orthopedics. PFNA-II, instead of having separate derotation and compression screws, has a single helical blade. The blade compacts the cancellous bone in femoral head when it is driven inside, which improves the femoral head strength and increases stability in cervico-cephalic direction^15 . Oldly we use PFN , DHS , TFN for the intertrochanteric femur fracture but now a days PFNA2 used because of its unique properties ,High functional outcome , less surgical time & less complication rate as compared to previously used implants & Techniques. Objectives: 1. To evaluate the functional outcome of PFNA 2 in treatment of intertrochanteric femur fracture in reference to fracture union, pain, mobility , postoperative infection , post operative morbidity Material and Methods: This Descriptive Longitudinal type of Study was conducted on 31 patients of intertrochanteric femur Fracture in old Age (>70 Years) at department of Orthopaedics at Dr. Balasaheb Vikhe Patil Rural Medical College, PMT-PIMS (DU), Loni Hospital for a period of 24 months Interpretation and conclusion:  Thirty-one patients with intertrochanteric femur fractures were included in our study; these patients were categorised using the AO classification system.  We evaluated the technical challenges associated with two bony entrance points: the greater trochanter's tip and a small distance (about 5 mm) medial to it.  It becomes challenging to insert nails when the entry point is off, necessitating the use of an insertion jig.  It was discovered that Proximal Femoral Nail Antirotation - II (PFNA-II) had a brief operating time. • The nail's flexible tip and lateral flattened cross-section facilitate insertion. The operative time is further decreased when proximal locking is accomplished with a single helical blade.  Even in cases of severe osteoporosis, the helical design of the proximal locking blade is suitable for guaranteeing a firm purchase in the femur head and neck.  In the majority of patients, the Harris Hip score indicated an excellent to good functional result.  When used in osteoporotic patients, this implant creates a stable structure and lowers the On the third post-operative day, the majority of the patients in our study were mobilised by beginning toe-touch weight bearing.  Because of severe fracture comminution, less than 25% of the patients started delayed weight bearing at 6 weeks after surgery.  Early mobilisation prevented complications associated with recumbency and allowed patients to return as soon as possible to their pre-frail status.  To treat stable and unstable intertrochanteric fractures, particularly those in the elderly and those linked to osteoporotic bone, PFN A-II is, in short, a stable, biomechanically appropriate implant with a specialised design that offers clear advantages over alternative implants.  The benefits of PFN A-II are noteworthy, and the minimal rate of complications can be achieved with the right surgical method.

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Dr Dhairya LALCHETA , Dr Kailash Ghorpade , Dr Prafulla Herode , Dr Ashish Somani, & Dr Chaitanya Khanolkar (August-2024). “FUNCTIONAL OUTCOME OF FRACTURE OF INTERTROCHANTERIC FEMUR IN OLDER PATIENT WITH PROXIMAL FEMORAL NAIL(PFN) A2 AT PRAVARA RURAL HOSPITAL , LONI”. INTERNATIONAL JOURNAL OF NOVEL RESEARCH AND DEVELOPMENT, 9(8), d264-d271. https://ijnrd.org/papers/IJNRD2408365.pdf

Volume 9 Issue 8, August-2024

Pages : d264-d271

Paper Reg. ID: IJNRD_226859

Published Paper Id: IJNRD2408365

Research Area: Medical Science

Author Type: Indian Author

Country: Loni, ahmadnagar, Maharashtra , India

Published Paper PDF: https://ijnrd.org/papers/IJNRD2408365.pdf

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Journal Name: INTERNATIONAL JOURNAL OF NOVEL RESEARCH AND DEVELOPMENT(IJNRD)

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