Unstable trochanteric Fracture Fixation with P.F.N. augmented by T.B.W.

Dr. Vijay Patil; Dr. Pandurang  Daule; Dr. Deepak Naikwade

doi:10.46858/vimshsj.8108

Authors

Dr. Vijay Patil DVVPF's Medical College & Hospital, Ahmednagar-414111, Maharashtra, India
Dr. Pandurang Daule
Dr. Deepak Naikwade

DOI:

https://doi.org/10.46858/vimshsj.8108

Keywords:

Augmentation, Proximal Femoral Nail, Unstable Trochanteric fracture, Lateral trochanteric wall, Communicated fragments

Abstract

Biomechanically Proximal Femoral Nail (PFN) is a better choice of implant. Still it is associated with screw breakage, cut out through femoral head,”Z” effect, reverse “Z” effect and lateral migration of screws. The purpose of this study is to evaluate the results of augmented PFN in terms of post operative complication and failure rates in unstable trochanteric fracture. Methodology: We did study of 21 unstable trochanteric fractures from Jan 2016 to Nov .2020. 14 patients were males & 7 patients were females. Age group between 25 to 80 was included in this group. There were 15 A0 A2 (2.2, 2.3) and 6 were A0 A3 (3.1, 3.2, 3.3). All fractures were fixed with 25cm, 135⁰PFN mainly 11 mm, 12mm in diameter augmented with one or two 16 gauge tension band wire, strengthening lateral trochanteric wall and holding either communiated fragments or lesser trochanteric fracture. Results: The bone healing was observed in all cases with mean period of 16 weeks. Two patients developed complication of TBW breakage; one developed lateral migration of screws. Patients were followed till # union. At the end of follow up the Salvati and Wilson hip function was 30 (out of 40) in 80% patients. Conclusion: The stabilization of lateral trochanteric wall fracture and communicated fragments with additional one or two TBW increases the stability of construct enhancing bony union & better results.

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