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

Evaluation of the clinical, functional and radiological results of the proximal femoral nail surgery for intertrochanteric femoral fractures in our clinic. 195 patients who were treated with proximal femoral nail (PFN) due to femur intertrochanteric fracture between January 2014 and January 2018 and at least 6 months follow up were included in the study at Fırat University, Faculty of Medicine, Department of Orthopedics and Traumatology. Average follow up period was 18 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, 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. 15 patients (% 8) Type 1, 40 (% 20) Type 2, 46 (% 24) Type 3, 15 (%8) Type 4, 59 (% 30) Type 5, 20 (% 10) Type R were found in Evans Jansen type fractures were present of 195 patients. The average age of the patients was 74.0. Patients with at least 6 months' follow-up were included. Etiological cause were simple fall for % 87.5 of patients, traffic accident for % 9.5, falling from high for % 1.5 and gunshot wound for % 1.5. Duration of surgery was between 30-45 min. Bleeding amount was between 100 cc - 150 cc. It's detected that the duration till the surgery was 2.1 days, and total residency duration was 7.2 days. Complication rate was % 8.2. Most of union was seen at varus (% 2.4). 159 (% 72.5) patients were good, 24 (% 12.3) patients were acceptable, and 12 (% 6) patients were poor results have found for reduction quality. In functional evaluations performed with HKS, excellent results were obtained in 94 (% 48), good results in 70 (% 36), moderate results in 19 (% 10) and poor results in 12 (% 6) of 195 patients.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. 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: Proximal Femoral Nail, Intertrochanteric Femoral Fracture, Evans Jansen Classification, Fogagnolo Reduction Criteria, Evans Jansen Classification, Harris Hip Score.