Evaluation of the results of the proximal femoral nail surgery for intertrochanteric femur fractures

This study aimed to evaluate the clinical, functional, and radiological results of the patients who underwent proximal femoral nail (PFN) surgery due to intertrochanteric femur fractures (IFF). A total of 195 patients who underwent PFN surgery due to IFF in January 2014 and January 2018 in our institute and with at least six months follow-up periods were included in the study. Demographic data, comorbidities, Evans-Jensen fracture classification, anesthesia risk scores, hospitalization duration, time to surgery, duration of surgery, amount of blood loss, whether additional traumas exist, quality of reduction, complication rates, Harris hip scores (HHS), Fogagnolo Reduction Quality criteria and possible correlations between these variables were evaluated retrospectively. In our study, the majority of the patients were found to be between the ages of 70-90. Hypertension was found to be the most common comorbid disease in the patients (50.2%). The fracture type of the majority of the patients was determined as type 4. The majority of patients were identified as ASA III and ASA IV group patients (38.4% and 35.9%, respectively). Successful HHS was found at a rate of 77.5%. As the fracture type worsened, the HHS score worsened (p<0.05). Reoperation rates were significantly lower in those with good reduction quality than those with poor reduction (p<0.05). A significant association was found between the overall complication rate and reduction quality (p<0.05). A significant and negative correlation was found between HHS scores and total complication rates (p<0.05). Intertrochanteric femur fractures are frequently encountered by orthopedists. These fractures, which require surgical intervention in almost all of them, are important because the population is old and prone to complications, and accurate and rapid surgical intervention is required. Our results suggest that PFN surgery is an appropriate choice for IFF.

Keywords: Proximal femoral nail, Intertrochanteric femur fractures, Harris hip score, ASA score