Results of proximal femoral nail in intertrochanteric fractures of the hip with compromised lateral femoral wall: a clinical outcome study

The ideal method of fixation of intertrochanteric fractures of femur associated with compromised lateral femoral wall is still not clearly defined. The aim of the present study is to evaluate the outcome of proximal femoral nail in unstable intertrochanteric fractures with compromised lateral femoral wall in terms of low rate of complications and re-operation.Twenty-four consecutive patients who had sustained an unstable intertrochanteric fracture according to AO/OTA classification were operated with proximal femoral nail under image intensifier by a single surgeon within a week of sustaining trauma and were followed clinically and radiologically for at least 6 months.Twenty-three patients were available for follow-up after 24 weeks. One patient died due to effects of prolonged immobilization 2 months postoperative as the patient wasn't able to bear weight on affected extremity due to screw cut-out and subsequent varus collapse in immediate postoperative period. There was a mean limb length shortening of 4.29 mm. In 19 of 23 (approx 83%) patients the shortening was less than 10 mm. Four of 24 patients (16%) had developed postoperative complications but none of the patients were re-operated during the subsequent follow-up of 6 months.Proximal femoral nail provides a good outcome in intertrochanteric fractures of the hip with fractured or compromised lateral femoral wall with an acceptable rate of technical difficulties and complications.