AN EXPERIENCE OF THE TREATMENT OF UNSTABLE INTER-TROCHANTERIC FRACTURES WITH THE AO/ASIF PROXIMAL FEMORAL NAIL

Objective: To evaluate the use of local-made proximal femoral nail in the treatment of unstable intertrochanteric femoral fractures. Methodology: This descriptive study was conducted in the Department of Orthopaedics, Lady Reading Hospital, Peshawar, from February 2009 to June 2010. Sixty-two patients with unstable inter-trochanteric femoral fractures, admitted through the Accident & Emergency Department were included in this study. All patients were treated with AO/ASIF proximal femoral nail and followed at least till fracture consolidation which takes minimum of 6 months. Results: The mean age of the patients was 74.27+ 5.84 years. Two patients died and thirteen patients were lost to follow-up. The results are thus based on a sample of 47 patients. There were no complications in 81% (n=38) patients and they achieved fracture consolidation within six months. Three patients underwent revision surgery due to non-union; two had lag screw penetration into the hip joint, three patients developed deep wound infection while one patient developed superficial wound infection. The mean pre injury mobility score was 6.8+2.5 while the mean post-operative mobility score was 6.48+2.7 (p=.000). Conclusion: The advantage of immediate stability in difficult and unstable fractures, and the relatively few complications serve to recommend the wider use of AO/ASIF proximal femoral nail.