Title-Functional Outcome, Radiological Union and Associated Complication of Unstable Traumatic Inter Trochanteric Fractures Treated with Cephalomedullary Nails at Tikur Anbessa Specialized Hospital, Addis Ababa University.
No Thumbnail Available
Date
2025-08-01
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Background: -Femur is the largest and strongest long bone in human skeleton. The proximal part of the femur includes three parts; Femur neck which is intra-capsular part of the proximal Femur, Inter-trochanteric area which includes the region between greater and lesser trochanter, and sub trochanteric area which is within 5cm below the lesser trochanter. Proximal femur fracture is a common fracture in the elderly population following simple ground level fall down and also common in the young population following high energy injury. The prevalence of proximal femur fracture in the senior population is increasing alarmingly recently as the life expectancy is increasing. Being the largest and tertiary referral hospital, Tikur Anbessa specialized hospital receives and treats a lot of both elderly and young patients with proximal femur fracture from all over the country. Almost all of these patients, unless they have clear contra-indication for surgery, were treated with some form of surgical intervention. Some of the surgical methods used to treat proximal femur fracture in our setup includes Sliding hip screw, Cephalo-medullary nails, Cannulated hip screw, Angle blade plates, SIGN intra-medullary nails, Hemi-arthroplasty and total hip arthroplasty. Clinical study on Functional and Radiological outcome of patients following Cephalo-medullary nail fixation for Proximal Femur fracture and associated complications was first in its’ type both in our center and country. Objective: -The main objective of this study is to know Functional outcome and radiological union of patients with Unstable Traumatic inter-trochanteric Fractures fixed with Cephalo medullary Nail and its associated complications at TASH,AAU. Methods: -A single center Cross-sectional retrospective study design was used for the purpose of this research. All patients for whom CMN was done for proximal femur fracture since 2018G.C to August 2024 G.C were collected from Operation theatre log book and Orthopedics and Trauma surgery department daily operation theatre schedule and were included in to this study if they full-fill the inclusion criteria of the study. The data was collected using the Questionnaires developed by the principal investigator and Modified harris hip score. The data was entered using Epi Info and analyzed using SPSS version 27. Descriptive statistics was used to describe socio demographic status of patients. Graphs, pie charts and tables were used for presentation of results. IX Bivariate correlation was used to study the relation between dependent and independent variables. Ethical clearance was obtained from the research ethical review board (IRB) of Tikur Anbessa Specialized Hospital, TASH Addis Ababa University. Result: - Among 127 study participants 65.35% were males. About 32.3% of the study participants were aged 50years or younger(15.7% were 51-60years,18.9% were 61 70years,23.6% were 71-80years and 9.4% were older than 80years).Falling down injury was the commonest cause of proximal femur fracture in our study accounting for about 66.14% followed by road traffic injury which accounts for about 26.77%.According to our study functional outcome of our patients using modified Harris hip score shows that only about 52.8% of the participants had good and excellent functional outcome.26% of the participants had poor outcome and 21.2% had fair functional outcome. All study participants had achieved radiologic union. The most common complication identified in our patients for whom cephalo-medullary nailing was done for an indication of unstable traumatic intertrochanteric fracture were post op infection (8.7%), helical blade back out (7.9%), and re-operation with in first year of surgery was done in about 3.9% of the participants. Age of the patient, patients with comorbidity and helical blade back out were found to have significant positive correlation with modified Harris hip score of the patients.1year mortality in patients for whom cephalo-medullary nailing was done for unstable traumatic IT fracture was about 17.3%. Older patients with one or more comorbidity were more likely to die within 1year after cephalomedullary was done for proximal femur fractures. Conclusion: -About 24% of the study participants had excellent functional outcome using modified Harris hip score and 28.8% of the study participants had good functional outcome. The remaining 47.2% of the study participants had fair and poor patient reported functional outcome as measured using Modified harris hip score. All study participants for whom cephalo-medullary nailing was done for an indication of Unstable traumatic IT fractures had achieved radiologic union with in 1year of surgical intervention. Post op infection and helical blade back out were the two commonest complications identified in our study participants.
Description
Keywords
Functional outcome, Modified Harris hip score, Proximal femur fracture