EFFECTIVENESS OF INTRAMEDULLARY FIXATION IN THE TREATMENT OF SUBTROCHANTERIC FEMORAL FRACTURES

Desired Objective: Purpose of this study is to converse operative efficiency, surgical methods and clinical results of intramedullary fixation in the treatment of subtrochanteric femoral fractures Study Design: Descriptive and observational study. Place and Time Frame: Subject study is carried out in Orthopaedic Surgery Department of Mayo Hospital Lahore within time frame of about one year (December 2017 to November 2018). Methodology: In above stated time frame the total 63 persons (41 men and 22 women) who visited our hospital with the cases of subtrochanteric femoral fractures were taken for study. All these cases are dealt by the intramedullary fixation. Age group was 35-69 years with mean of 52 years. All cases are categorized as per the Seinsheimer Classification and the cases were as 3, 5, 12, 19 and 24 cases of type-I, type-II, type-III, type-IV and type-V respectively. In starting phase, all the persons were suffered from closed reduction as per the C-arm fluoroscopy. Very small quantity of cases experienced the ultimate closed reduction with following of internal fixation. Rest all the cases required extra inadequate open reduction. We use the radiographic tests to make the testing confirmations of fracture therapeutic and bump structures in post-operative follow up of one, two, three and twelve months. By using the Harris Hip Scoring HHS system, the functional recovery of all cases is assessed. Closed reduction of the all fracture is in the management of C-arm fluoroscopy. In our study cases of ideal closed reduction was observed in one case of type-I and the 2 cases of type-III and treated by internal fixation. Results: Almost all subtrochanteric femoral fractures were recovered with the exception of only one case that was not cured in time and got long time recovery. The average recovery time of bone union was 4.1 months. The functional recovery ratio as per the reference of Harris Hip Scoring HHS system was categorized as 54, 7, 2, and 1 case with categories of Excellent, Good, Fair and Poor respectively. Functional recovery ratio of the first three categories in contrast with poor had the percentage of 98.41%. Conclusion: The Intramedullary fixation is effectively practicable the treatment of subtrochanteric femoral fractures but with the follow up of long-time frame. For the clinical outcomes the expertise in surgery and the accuracy of intra-operative reduction is necessary.