Abstract

INTRODUCTION:
Intertrochanteric fractures are commonly seen in patients over 70yrs of age. In younger population, intertrochanteric fracture occurs due to high velocity trauma, whereas in elderly population, it is most often due to trivial trauma.Cephalomedullary device is used for management of intertrochanteric fracture
OBJECTIVES :
 To compare the surgical results in patients with inter-trochanteric femur fractures Treated by PFN with and without distal locking .
METHODOLOGY:  In a prospective study 40 patients were enrolled with mean age 59.05 years with proximal femur fracture which included 25females and 15 males who underwent Long proximal femoral nail with distally locked and distally unlocked. AO system of classification was used. 31 A1 was the commonest type. Operative time, overall fluoroscopy shots, intra-operative blood loss, the duration of hospitalization, and the surgical complications were noted. Patients were followed up at 6weeks, 3months, 6 months. Functional outcome assessed according to the Harris hip scoring system.
RESULTS:
            Mean age of 59.05 years in PFN without distal locking and 54.75 years in PFN with distal locking.  Mean duration of surgery in PFN without and with distal locking was 40.45 & 54.75 mints respectively.  Mean amount of blood loss  in PFN without  and with distal locking 154.7 ml and 206.3 ml respectively .Mean length of incision in PFN without  and with distal locking was 10.95  & 12.65 cm respectively.  Mean fluoroscopic time in PFN without and with distal locking was 61.3 & 71.3 shots respectively. Mean duration of hospital stay in Group A & B is 15.3 & 15.2 days respectively . Out of 40 cases no case was lost in follow up.  we had good to excellent results in 90%, fair in 10%, we had no case with poor results.
CONCLUSION:
             From this study, we consider that long proximal femoral nailing without distal locking shows subtle advantages for duration of surgery, amount of blood loss, incision length ,fluoroscopy exposure time ,post-op stiffness in stable  intertrochanteric fracture.