Evaluation of the results of the proximal femoral nail surgery for intertrochanteric femoral fractures

Objective: Evaluation of the clinical, functional and radiological results of the proximal femoral nail surgery for intertrochanteric femoral fractures in our clinic. Method: The study contains 40 patients that we applied proximal femoral nail because of the intertrochanteric femoral fractures and who have at least 6 months follow-up in Department of Orthopedics and Traumatology between May 2009-October 2014. Average follow up period was 12 months. The clinical, functional and radiological findings of patients has been been examined retrospectively. In this study the patients' demographic data, comorbidities before the surgery, risk for anesthesia before the surgery (ASA), residence duration in hospital, duration passed till the surgery, surgical duration, amount of bleeding, whether additional traumas exists, reduction quality, mechanic complication rates, Harris hip score (HKS) criteria for functional evaluation and correlations between these variables has been evaluated. The Evans Jansen classification is used for identification of fractures. The Fogagnolo Reduction Quality criteria are used for radiological evaluation. Finding: Cannulated Proximal Femoral Nail (PFN), (ZIMED, TURKEY) surgery method was applied to 20 of 40 patients, Talon Distal Fix Nails PFN (ODİ-NA) surgery method is applied to 16 of 40 patients, PFN (SYNTHES) surgery method is applied to 4 patients. The average age of the patients was 72.0. Etiological cause were simple fall for 90% of patients, motor vehicle accident for 5%, and fall from high for 5%. Duration of surgery was between 40-80 min. Bleeding amount was between 150 cc - 200 cc. It's detected that the duration till the surgery was 3.1 days, and total residency duration was 9.1 days. Mechanical complication rate was 17.5%. Most of union was seen at varus (10%). 10% bad, 90% good and acceptable results have found for reduction quality. 77.5% perfect and good results obtained in functional evaluation with HKS scoring system. The statistical analysis of the data studied by a biostatistician, who was out of the writer team, with SPSS for Windows 22.0. In analysis of the data. Spearman rank corelation coefficient, x-square test (Crosstabs Chi-Square) was used. <0.005 p values was accepted as significant. Conclusion: In conclusion, we decided that PFN should be chosen in suitable cases because of the low bleeding amount, low surgery time, toleration of quick mobilization, good reduction qualities and good functional results after surgery. Keywords: Intertrochanteric Femoral Fracture, Proximal Femoral Nail, Fogagnolo Reduction Criteria, Evans Jansen Classification, Harris Hip Score.