Comparisonof efficacy of extramedullary fixation devices and proximal femoral nail in the management of subtrochanteric fracture femur

Hip is one of the important joint for locomotion in human beings. So fractures in and around hip joint are of great concern to treatingsurgeon and patient. Wehavemade an attempt to evaluate these complex fractures and compared the efficacy of proximal femoral nail and extamedullary devices in treatment of subtrochanteric fracture femur.

After informed consent was given, all 56 consecutive patients with subtrochanteric fracture of femur were randomized into two treatment groups. One group of patients were treated with dynamic hip screw or Dynamic condylar screw (Group I) and other group received proximal femoral nail (Group II). All procedures were performed by staff surgeons with patient supine on a fracture table.

The mean operative time in Group I (93.57 min) was significantly higher than in Group II (80 min) with a P value of < 0.01. Average blood loss in Group I (190.14ml) was 2.4 times higher than in Group II (78.35 ml) with a P value of 0.008. There was no significant statistical difference between the two groups with regard to general complications.

We conclude that subtrochanteric fractures are difficult to understand and manage. We consider that the PFN is a good minimally invasive implant for unstable proximal femoral fractures when closed reduction is possible. In general, PFN afforded early return to physical activity, faster rehabilitation & walking ability, lesser blood loss and comparablesuccess rate.