Long PFN nailing in comminuted high subtrochanteric fractures femur in lateral position on ordinary table
Journal Title: Indian Journal of Orthopaedics Surgery - Year 2018, Vol 4, Issue 3
Abstract
Introduction Most of the hip fractures are managed in supine position on a fracture table with foot attached to foot plates and biplanar fluoroscopy supervision under carm But this procedure has its own difficulties in managing especially comminuted subtrochanteric fractures where in different fragments and segments are being pulled by strong muscles around hip and getting good reduction and alignment is difficult due to displaced bony fragments being held in traction on fracture table and cannot be manipulated easily This leads to prolonged operative time opening of fracture site increased bleeding increased chances of infection and over all increased anaesthesia time adding up to risk factors The purpose of this study was to report how these difficulties can be overcome by operating on a simple radioluscent top operating table in lateral position without a fracture tableMaterials and Methods 74 cases of subtrochanteric fractures with or without comminution were operated in lateral position on simple ordinary radioluscent top table with lesser attachments and adjustments to operating table during the study duration were included in the study We used long Proximal Femur Nail PFN length more than 25cms 34 36 38 40cms long to fix these fracturesResults In the present study age group of patients was 25yrs to 74yrs Male patients 837 were more than female patients 163 An average of less than 150 ml in closed surgery The average operative time for all cases was 80 minutes Union time varied from 16 weeks in simple fractures to 26 weeks in comminuted fractures Clinical function of hip and knee was excellent with full range of movementsConclusions Reduction and fixation of proximal femoral fractures in the lateral position with fluoroscopy or portable radiography in the anteroposterior view for small set ups and rural hospitals that lack a fracture table or advanced fluoroscopic devices may be executable and probably safeKeywords Long PFN Subtrochanteric fracture Lateral position Ordinary operating table
Authors and Affiliations
Shashikant B. Ganjale
Keywords
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- EP ID EP476645
- DOI 10.18231/2395-1362.2018.0054
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