FUNCTIONAL AND RADIOLOGICAL OUTCOME IN SUBTROCHANTERIC FRACTURES OPERATED WITH RECON INTRAMEDULLARY NAILING - A PROSPECTIVE STUDY

Abstract

Subtrochanteric fracture of the femur is a challenging fracture due to complex biomechanics, fracture instability and difficulty in achieving satisfactory reduction. Seventeen patients with subtrochanteric femoral fractures were reconstructed with intramedullary nailing, and this prospective observational study examined functional and radiological results. Functional recovery was evaluated by the Harris Hip Score (HHS), and radiographic healing was evaluated by the Radiographic Union Score for Hip (RUSH) at 6, 12 and 24 weeks after surgery. Fracture union, operative characteristics and postoperative complications were also recorded. Functional improvement on the Mean HHS was statistically significant (p<0.001) and went from 48.59 at 6 weeks to 85.00 at 24 weeks. Progressive radiographic consolidation was observed as Mean RUSH increased from 11.94 to 26.00. The radiographic union was achieved in 15 patients (88.2%) with a mean time of 14.13 weeks. In 2 patients, there was incomplete consolidation. There were significant positive correlations between functional scores and radiological scores at all time points during follow-up. There were no serious implant failures or re-operations reported. The results of the reconstructed IM nail were encouraging in terms of functional and radiological outcomes in the short term. Larger comparative trials with longer duration of follow-up are needed, however, to provide evidence of long-term effectiveness, safety, and generalizability in a broader range of patient populations.