A study of unstable intertrochanteric fractures treated with trochanteric fixation nail

Background: Intertrochanteric (IT) fractures are common injuries that most commonly affect the elderly but are also seen in younger age patients. Understanding of Biomechanics of the fracture and also development of implants had led to improvement in the treatment modalities available for these patients. Trochanteric Fixation Nail were developed to improve the rotational stability of the proximal fracture fragment and the tip of the nail was re-designed with reduction of the distal diameter of the nail to decrease the risk of intra and postoperative fractures of the femoral shaft by a significant reduction in bone stress. Materials and methods: The study was done on 40 patients with unstable intertrochanteric fracture treated with trochanteric fixation nail. The patients were followed up at 4th week, 6th week, 3rd and 6th months. All surgeries were done by the same surgeon. Average length of incision, intraoperative blood loss, duration of surgery, intraoperative complications, postoperative infection, duration of hospital stay, range of movements, shortening of limb, implant failure, union time, periprosthetic fracture and any additional surgical procedure done were studied. Functional outcome was assessed based on Kyle’s criteria. Results: There was decrease in size of incision, intraoperative blood loss, duration of surgery, hospital stay with Trochanteric Fixation Nail. Range of movement was good to excellent in almost all cases. No periprosthetic fracture was seen in any patients. Conclusion: Our study conclude that Trochanteric Fixation Nail is a significant advancement in the treatment of unstable intertrochanteric fractures which has the unique advantages of closed reduction, preservation of fracture hematoma, less tissue damage, early rehabilitation and early return to work.