Results of “Trochanteric Femoral Nailing (TFN)” in comminuted unstable trochanteric fractures

Abstract

Unstable trochanteric fractures and fractures with reverse obliquity pose difficulty in fixation. In recent years, intramedullary nails, for the treatment of comminuted and unstable intertrochanteric hip fractures, are becoming more popular relative to conventional, sliding hip screws.

The purpose of our study was to evaluate the result of Trochanteric femoral nailing in comminuted, unstable Trochanteric femur fracture in terms of anatomical restoration and functional outcome.

It is a prospective and without control study. Trochanteric femoral nailing has been done in comminuted unstable inter-trochanteric fracture femur (AO A2.2 to A3.3) of 25 patients and they are followed up postoperatively for at least 12 months. Pre-operative and post-operative clinical and radio-logical parameters are compared accordingly.

Union in all cases. Overall complication rate 12% including some implant related complications. Functional outcome on Harris Hip Score is comparable with standard literature.

For treatment of intertrochanteric hip fractures, particularly with comminuted fracture fragments, intramedullary devices offer beneficial features, such as closed insertion, a shorter lever arm, and controlled telescoping of the head-neck fragment.

Insertion of the nail through the tip of the greater trochanter requires less dissection and may lead to less blood loss and fewer wound complications, as well as earlier postoperative mobility. Further biomechanical and clinical studies are necessary to validate the efficacy of the trochanteric femoral nail.

Level of Evidence : Level III therapeutic study.