Comparative Study of Antegrade Femoral Nailing Vs Proximal Femoral Nailing For the Treatment of Proximal Femoral Fractures

Abstract

BACKGROUND For unstable intertrochanteric femoral fractures, the treatment options are innumerous, though the implant choice is debatable. In our institute we use proximal femoral nail and antigrade femoral nail for the treatment of unstable intertrochanteric femoral fractures. AIM & OBJECTIVE  To study and compare the clinical results and functional outcome of various implant used for treatment of unstable intertrochanteric fractures routinely used in our institute Proximal femoral nail and Antegrade femoral nail.  To review the available literature concerning these implants for treatment of Unstable Intertrochanteric Fractures. MATERIALS AND METHOD: We have operated total 40 cases with unstable intertrochanter fracture. We have treated patient with proximal femoral nailing and antigrade xii femoral nailing.Clinical outcome and function results were evaluated by salvati Wilson hip score. RESULT: We have operated total 40 cases with proximal femoral nailing and antegrade femoral nailing in unstable intertrochanteric fracture. average union time was in AFN (13.5 weeks) and in PFN(11.9 weeks). We have achieved 70% of excellent result in both. But fair result in PFN 10% and 15% in AFN. CONCLUSION: With strict adherence to anatomical reduction, proper fixation and proper in time regular physiotherapy protocol, We get satisfactory results in all cases treated by cephalocondylar nail. Normally antegrade femoral nail (AFN) is entered just lateral and distal to tip of greater trochanter which makes it vulnerable to pass through the fracture site, thus creating a gap between proximal and distal fragment. Thus, we suggest that though antigrade femoral nail is good implant for subtrochanteric fracture element. It’s use in intertrochanteric fracture has got inferior outcome compared to proximal femoral nail thus making proximal femoral nail more preperable implant for treatment of intertrochanteric fracture.