Surgical treatment results of adult femoral pertrochanteric fractures with proximal femoral nail

Surgical Treatment Results of Adult Femoral Pertrochanteric Fractures With Proximal Femoral Nail Objective: Functional and radiologic results of 109 consecutive patients with intertrochanteric femur fractures, who were undergone osteosynthesis by Veronail® nail at Inonu University Medical School Orthopedics and Traumatology Clinic between October 2009 and January 2015, were examined retrospectively. Materials and Methods: Besides the demographic properties, type of fracture, comorbidities, type of trauma, time to surgery, operation time and complications have been evaluated. Radiologically, presence of union and position of the implant were evaluated. American Society of Anaesthesiologist (ASA) scale used for surgical risk assesment. Harris Hip coring System was used for functional evaluation. Results: 59 patient were male and 50 were female. The mean age was 77,69 (17 -102 year). The mean follow up time was 32,9 (12-61 months). The etiology was simple fall in %89.9, falls from height in %7,3 and motor vehicle accidents in %1,8. Operative procedures were performed within average 3,54 days after admitted to our hospital (range, 0-17 days). Average length of hospital stay was 7,76 days (range 2-56 days). We found nonunion and implant failure in one patient, femur diaphysis fracture in one patient, nonunion in one patient ,cot out of proximal screws in two patient and secondary varus malposition in two patients. Mean Harris hip score was 79,6 (48-100) at the last follow up. The mortality rate at first year was %29,6. High ASA score and being over 80 years of patient has been found to generate statistically significant increase risk in mortality and poor functional outcome. Conclusion: Pertrochanteric fracture are usually diagnosed in elderly patients due to low energy traumas. The first choice off treatment must be surgical for early return to prefracture activity levels. The proximal femoral nail is a reliable, safe and effective treatment method for pertrochanteric fractures because of the advantages like application with closed reduction, providing anatomic and biological fixation, short surgical time, low blood loss and complication rate and allowing early weight bearing. Key Words: Intertrochanteric fractures, proksimal femoral nail, Harris hip score.