Early Functional Outcome of Proximal Femoral Nail Antirotation in Treatment of Unstable Intertrochanteric Fractures

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Abstract Background: Fractures of the hip are common injuries. Approximately 50% of hip fractures occur in the intertrochanteric region, the prevalence of which increases exponentially with age. It is also associated with a high rate of morbidity and mortality. Beyond preventing avoidable deaths, the goal of the treatment is to restore patients to their pre-injury level of mobility. (5) Achieving stable reduction and fixation of the fracture, permitting immediate mobilization, is key to these goals. Methods: This is a descriptive cross-sectional hospital-based design study to evaluate the early Functional outcome of proximal femoral nail anti-rotation in the treatment of unstable intertrochanteric fractures conducted in 3 centers, and the total number in our study was 40 cases. Data were collected through a questionnaire that included patient data and analyzed using SPSS software (IBM Version-26). Results: Out of the Forty patients with an unstable intertrochanteric femur fracture (fractures A2.2 through A3.3), operated with PFNA enrolled in this study, 22 were males and the remaining were females. 24 patients had right hip fractures while 16 had left hip fractures. . Modified Harris Hip Score was used to assess postoperative pain, function, and functional activities. There is a statistically significant difference between the mHHS and the age group, the functional outcome was excellent in young patient and the more patient’s age the less functional outcome and gender, and most of our patients score were fair and good. 17 female patients are fallen in this category while 12 male patients. All excellent patients are male group. Conclusion: Unstable intertrochanteric fracture is common in the elderly due to osteoporosis and in the young due to high-velocity trauma. As the fracture is more common in the elderly (80% of our study group), early reduction and internal fixation increases patient comfort, facilitates nursing care, and helps in the early mobilization of the patient. We believed our study had shown that the PFNA works well in the treatment of unstable intertrochanteric fractures, post-operative pain was ignored in most of our patients, 60% had slight limping not compromised their daily activity, most of them used a cane for walking 2-3 blocks, 52.5% climbed the stairs with banister, 72.5% put on socks/shoes with ease, 95.0% sitting in any chair for a long time and 62.5% entered public transportation. The overall functional outcome of our patients falls between good and fair.

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