Comparison of Peri and Early Post-Operative Complications in Long Versus Short Proximal  Femoral Nail for Unstable Proximal Femoral Fractures

Authors

  • Shahid Munir Department of Surgery, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Imran Department of Surgery, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Jalil Malik Department of Surgery, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Arslan Sharif Malik Department of Surgery, Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan
  • Shahryar Wattoo Department of Surgery, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Hammad Rafique Department of Surgery, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i4.7882

Keywords:

Complications; Femoral fracture, Intramedullary nail.

Abstract

Objective: To compare peri and early post-operative complications in long versus short proximal femoral nails for unstable proximal femoral fractures.

Study Design: Quasi-experimental study.

Place and Duration of Study: Orthopaedic Department, Combined Military Hospital, Lahore Pakistan, Jan to Sep 2021.

Methodology: We included all the patients who suffered from unstable proximal femur fractures diagnosed by a consultant orthopedic surgeon based on clinical and radiological findings. They were randomly divided into two groups. Group-A was managed by a long proximal femoral nail, while Group-B was managed by a short proximal femoral nail. Both groups were compared for peri- and early post-operative complications.

Results: The final analysis included 110 patients. The mean age of the study participants was 63.66±8.553 years. 79(71.8%) were male, while 31(28.2%) were female. Peri- and early post-operative complications were not statistically different in both groups except for the duration of surgery. Patients undergoing long proximal femoral nail fixation had more chances of having surgery lasting more than 40 minutes than patients undergoing short femoral nail fixation (p-value-0.004).

Conclusion: The peri- and early post-operative complications rate was almost similar in both groups. Patients undergoing long proximal femoral nail fixation had more chances of having prolonged surgery than patients undergoing short femoral nail fixation.

Downloads

Download data is not yet available.

References

GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396(10258):1204-1222. Erratum in: Lancet 2020; 396(10262): 1562.

https://doi.org/10.1016/S0140-6736(20)32226-1

Testa G, Vescio A, Aloj DC, Papotto G, Ferrarotto L, Massé A, et al. Definitive Treatment of Femoral Shaft Fractures: Comparison between Anterograde Intramedullary Nailing and Monoaxial External Fixation J Clin Med. 2019; 8(8): 1119. https://doi.org/10.3390/jcm8081119

Kazley J, Bagchi K. Femoral Neck Fractures. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021.

Bäcker HC, Wu CH, Maniglio M, Wittekindt S, Hardt S, Perka C. Epidemiology of proximal femoral fractures. J Clin Orthop Trauma 2021; 12(1): 161-165.

https://doi.org/10.1016/j.jcot.2020.07.001

Mittal R, Banerjee S. Proximal femoral fractures: Principles of management and review of literature. J Clin Orthop Trauma 2012; 3(1): 15-23.

https://doi.org/10.1016/j.jcot.2012.04.001

Jackson C, Tanios M, Ebraheim N. Management of Subtrochanteric Proximal Femur Fractures: A Review of Recent Literature. Adv Orthop 2018; 2018(3): 1326701.

https://doi.org/10.1155/2018/1326701

Blum LE, Yee MA, Mauffrey C, Goulet JA, Perdue AM, Hake ME. Comparison of reamed long and short intramedullary nail constructs in unstable intertrochanteric femur fractures: A biomechanical study. OTA Int 2020; 3(2): e075. https://doi.org/10.1097/OI9.0000000000000075

Kanthimathi B, Narayanan V. Early Complications in Proximal Femoral Nailing Done for Treatment of Subtrochanteric Fractures. Malays Orthop J 2012; 6(1): 25-29.

https://doi.org/10.5704/MOJ.1203.009

Mehboob I. Proximal femoral nail in intertrochanteric femoral fractures. JNMA J Nepal Med Assoc 2009; 48(176): 273-275.

Shah SWA, Aslam MZ. Early outcomes of proximal femoral nail antirotation (PFNA) for unstable intertrochanteric femoral fractures. Pak Armed Forces Med J 2020; 70 (3): 711-714.

Attum B, Pilson H. Intertrochanteric Femur Fracture. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021.

Deleanu B, Prejbeanu R, Tsiridis E, Vermesan D, Crisan D, Haragus H, et al. Occult fractures of the proximal femur: imaging diagnosis and management of 82 cases in a regional trauma center. World J Emerg Surg 2015; 10 (3): 55.

https://doi.org/10.1186/s13017-015-0049-y

Gadegone WM, Salphale YS. Proximal femoral nail - an analysis of 100 cases of proximal femoral fractures with an average follow up of 1 year. Int Orthop 2007; 31(3): 403-408.

https://doi.org/10.1007/s00264-006-0170-3

Gadegone WM, Salphale YS. Short proximal femoral nail fixation for trochanteric fractures. J Orthop Surg 2010; 18(1): 39-44. https://doi.org/10.1177/230949901001800109

Matsumura T, Takahashi T, Nakashima M, Nibe Y, Takeshita K. Clinical Outcome of Mid-Length Proximal Femoral Nail for Patients With Trochanteric Hip Fractures: Preliminary Investigation in a Japanese Cohort of Patients More Than 70 Years Old. Geriatr Orthop Surg Rehabil 2020; 11(3): 2151459320936444.

https://doi.org/10.1177/2151459320936444

Barbosa TA, Souza AMF, Leme FCO, Grassi LDV, Cintra FB, Lima RME, et al. Perioperative complications and mortality in elderly patients following surgery for femoral fracture: prospective observational study. Braz J Anesthesiol 2019; 69(6): 569-579.

https://doi.org/10.1016/j.bjan.2019.09.004

Horwitz DS, Tawari A, Suk M. Nail Length in the Management of Intertrochanteric Fracture of the Femur. J Am Acad Orthop Surg 2016;2 4(6): e50-58.

https://doi.org/10.5435/JAAOS-D-15-00325

Vaughn J, Cohen E, Vopat BG, Kane P, Abbood E, Born C. Complications of short versus long cephalomedullary nail for intertrochanteric femur fractures, minimum 1-year follow-up. Eur J Orthop Surg Traumatol 2015; 25(4): 665-670.

https://doi.org/10.1007/s00590-014-1557-2

Downloads

Published

30-08-2024

Issue

Section

Original Articles

How to Cite

1.
Shahid Munir, Muhammad Imran, Muhammad Jalil Malik, Arslan Sharif Malik, Shahryar Wattoo, Hammad Rafique. Comparison of Peri and Early Post-Operative Complications in Long Versus Short Proximal  Femoral Nail for Unstable Proximal Femoral Fractures. Pak Armed Forces Med J [Internet]. 2024 Aug. 30 [cited 2024 Sep. 11];74(4):999-1002. Available from: https://pafmj.org/PAFMJ/article/view/7882