The effect of different anesthesia methods applied on postoperative clinical and functional results in pertrochanteric femur fractures with proximal femoral nailing

In this study, patients who underwent proximal femoral nail (PFN) surgery due to pertrochanteric femur fractures between 2020 and 2023 at Düzce University Faculty of Medicine, Department of Orthopedics and Traumatology, and met the inclusion criteria were analyzed. The primary aim of the study was to assess the effects of different anesthesia methods (general anesthesia, spinal anesthesia, and erector spinae plane (ESP) block) on postoperative clinical and functional outcomes. Patients were evaluated preoperatively based on their general health status, type of fracture, and planned anesthesia method. Postoperative evaluations included patient satisfaction, hip function, and pain scoring. The results indicated that each anesthesia method had its own advantages and limitations. General anesthesia provided better surgical control but could increase the risk of postoperative complications. Spinal anesthesia was found to enhance pain control, support early mobilization, and accelerate the recovery process. The ESP block also demonstrated efficacy in pain management and reduced the need for opioids. However, no single anesthesia method was definitively superior to others; each had specific benefits in different aspects. The impact of the proximal femoral nail on functional outcomes in the postoperative period was also explored. The findings highlighted that factors such as patient age, general health status, and fracture stability should be considered when selecting the anesthesia method. The study emphasized the importance of a multidisciplinary approach in managing elderly patients with femur fractures and showed that personalized treatment planning could positively influence patient outcomes. This study aimed to contribute to a better understanding of the effects of anesthesia methods and implants used during pertrochanteric femur fracture surgeries, guiding treatment approaches in clinical practice.