“UNSTABLE INTERTROCHANTERIC FEMUR FRACTURES TREATED BY TROCHANTERIC SUPPORT PLATE WITH PROXIMAL FEMORAL NAIL (PFN) GIVE BETTER FUNCTIONAL OUTCOME”
Main Article Content
Keywords
Unstable intertrochanteric fracture, trochanteric support plate, proximal femoral nail, Harris Hip Score, functional outcome, lateral wall comminution, hip fracture fixation
Abstract
Background:
Unstable intertrochanteric femur fractures, particularly those involving the lateral wall, present a significant challenge in orthopedic trauma care. Although Proximal Femoral Nail (PFN) fixation has become a standard treatment, lateral wall compromise can lead to mechanical failure. Augmentation with a Trochanteric Support Plate (TSP) may enhance fixation stability and improve functional outcomes. This study evaluates the efficacy of PFN with TSP in managing such fractures.
Methodology:
This prospective, observational, non-randomized study was conducted at MGM Medical College & Hospital, Aurangabad, from June 2023 to 2025. Thirty patients aged 30–80 years with unstable intertrochanteric femur fractures and compromised lateral walls were included. Patients underwent open reduction and internal fixation using PFN augmented with a TSP. Functional outcomes were assessed using the Harris Hip Score (HHS) at 6 weeks, 3 months, and 6 months postoperatively. Radiographic healing and complications were documented at each follow-up.
Results:
The mean age was 60.8 ± 14.35 years, with a male predominance (60%). The most common mechanism of injury was a fall from height (43.33%). Good quality of fracture reduction was achieved in 66.67% of cases. Functional recovery showed progressive improvement: 46.67% of patients had excellent outcomes (HHS > 90) at 6 months. Postoperative complications were minimal, with anterior hip pain (6.67%), screw migration (10.00%), and Z/reverse Z effect (6.67%) being the most noted issues. There were no cases of implant failure or avascular necrosis.
Conclusion:
Augmentation of PFN with a Trochanteric Support Plate in unstable intertrochanteric femur fractures yields superior functional outcomes and reduces the risk of implant-related complications. This technique provides enhanced lateral wall support, improves construct stability, and facilitates early mobilization, making it a valuable approach in managing complex intertrochanteric fractures.
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Dr. Rajendra N. Shewale
Professor at Department of Orthopaedics, MGM Medical College & Hospital Chhatrapati Sambhajinagar, Maharashtra, India
Dr. Abhishek Shinde
Assistant Professor at Department of Orthopaedics, MGM Medical College & Hospital Chhatrapati Sambhajinagar, Maharashtra, India
Dr. Kishor B. Kande
Junior Resident at Department of Orthopaedics, MGM Medical College & Hospital Chhatrapati Sambhajinagar, Maharashtra, India
Dr. Vemparala Subrahmanya Sastry
Junior Resident at Department of Orthopaedics, MGM Medical College & Hospital Chhatrapati Sambhajinagar, Maharashtra, India