Management of Trochanteric & Subtrochanteric Femoral Fractures by Proximal Femoral Nail: Current Experience at Misurata Medical Center in Libya

• Hussein Alhalloup

  Orthopedic Department, Faculty of Medicine, Misurata University, Misurata, Libya

  Author

• Ali Zaggout

  Orthopedic Department, Faculty of Medicine, Misurata University, Misurata, Libya

  Author

• Ali Glaisa

  Orthopedic Department, Faculty of Medicine, Misurata University, Misurata, Libya

  Author

• Emad Swayeb

  Orthopedic Department, Faculty of Medicine, Misurata University, Misurata, Libya

  Author

• Alhadi Alsaghaier

  Orthopedic Department, Faculty of Medicine, Misurata University, Misurata, Libya

  Author

Extra-capsular proximal femur fractures are prevalent, particularly among the elderly population with osteoporosis, typically resulting from low-energy trauma. In younger adults, these fractures are often associated with high-velocity trauma. The incidence of these fractures is escalating due to the increasing demographic of senior citizens afflicted with osteoporosis. Proximal femoral fractures are associated with substantial morbidity and mortality, malunion, implant failure, and various co-morbid medical conditions. Consequently, this has driven the development and adoption of intramedullary devices for the management of proximal femoral fractures. This study aims to analyze the efficacy and functional outcomes associated with the use of proximal femoral nails (PFN) in the treatment of proximal femoral fractures. A retrospective cohort study was conducted involving 143 adult patients who presented with proximal femoral fractures and were treated with proximal femoral nailing at Misurata Medical Center, Libya, between 2014 and 2019. The study included trochanteric and subtrochanteric fractures, which were classified according to the Boyd & Griffin and Seinsheimer classifications, respectively. All patients underwent regular follow-up assessments as per the study protocol. Functional outcomes were evaluated using the Harris Hip Score. The study cohort comprised 90 cases of trochanteric fractures and 53 cases of subtrochanteric fractures, all of which underwent surgical fixation with a proximal femoral nail. Functional outcomes, as assessed by the Harris Hip Score, demonstrated excellent results in 62 cases (43%), good in 42 cases (29%), fair in 24 cases (17%), and poor in 15 cases (10%). Complications encountered during the study were meticulously tracked and managed with appropriate interventions. The findings of this study indicate that the proximal femoral nail is a reliable implant for the management of proximal femoral fractures. Its application leads to a high rate of bone union, restoration of anatomical alignment, and a reduced incidence of implant failure or deformities. Intramedullary fixation offers biological and biomechanical advantages, contributing to decreased morbidity and an improved functional quality of life for patients.

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