Comparative Study Between Short Proximal Femoral Nail and Long Proximal Femoral Nail in Management of Intertrochanteric Fractures

Abstract

Pranavkumar Jagdishbhai Pandya, Dr. Sudhirkumar Rawat and Dr. Dhairya H. Gandhi

Background: Intertrochanteric fractures are among the most common orthopedic injuries in the elderly population and are associated with significant morbidity and mortality. Proximal femoral nailing (PFN) has emerged as a preferred treatment modality because of its biomechanical advantages, minimally invasive approach, and ability to provide stable fixation. However, the choice between short proximal femoral nail and long proximal femoral nail remains controversial, with each implant having distinct advantages and limitations in terms of surgical parameters, biomechanical stability, and postoperative outcomes.

Aim: To evaluate and compare the surgical and functional outcomes of short proximal femoral nail and long proximal femoral nail in the management of intertrochanteric fractures.

Objectives: To assess the rate and time of fracture union in patients treated with short and long PFN and to analyze the complications associated with each implant type.

Methodology: A prospective observational study was conducted in the Department of Orthopaedics at SBKS Medical Institute and Research Centre, Dhiraj Hospital, Gujarat, India. Patients with intertrochanteric fractures were managed using either short PFN or long PFN depending on fracture characteristics and surgeon preference. Outcomes assessed included operative parameters, fracture union, functional recovery, and postoperative complications.

Background: Intertrochanteric fractures are among the most common orthopedic injuries in the elderly population and are associated with significant morbidity and mortality. Proximal femoral nailing (PFN) has emerged as a preferred treatment modality because of its biomechanical advantages, minimally invasive approach, and ability to provide stable fixation. However, the choice between short proximal femoral nail and long proximal femoral nail remains controversial, with each implant having distinct advantages and limitations in terms of surgical parameters, biomechanical stability, and postoperative outcomes.

Aim: To evaluate and compare the surgical and functional outcomes of short proximal femoral nail and long proximal femoral nail in the management of intertrochanteric fractures.

Objectives: To assess the rate and time of fracture union in patients treated with short and long PFN and to analyze the complications associated with each implant type.

Methodology: A prospective observational study was conducted in the Department of Orthopaedics at SBKS Medical Institute and Research Centre, Dhiraj Hospital, Gujarat, India. Patients with intertrochanteric fractures were managed using either short PFN or long PFN depending on fracture characteristics and surgeon preference. Outcomes assessed included operative parameters, fracture union, functional recovery, and postoperative complications.

Results: Short PFNs demonstrated advantages in terms of reduced operative time, lower blood loss, decreased fluoroscopy exposure, and ease of insertion. Long PFNs provided superior biomechanical stability, especially in unstable fractures, subtrochanteric extension, and osteoporotic bone, with reduced stress concentration and lower risk of peri-implant fractures. Functional outcomes and fracture union rates were generally comparable between the two implants, while implant selection was found to depend largely on fracture morphology, bone quality, patient comorbidities, and surgeon expertise.

 

 

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