~ 865 ~ International Journal of Orthopaedics Sciences 2017; 3(4): 865-870 ISSN: 2395-1958 IJOS 2017; 3(4): 865-870 © 2017 IJOS www.orthopaper.com Received: 29-08-2017 Accepted: 30-09-2017 Dr. Kamal Kumar Arora Assistant Professor, Department of Orthopaedics GMC, Amritsar, DRME, Punjab, India Dr. Simran Jit singh Senior Resident GMC, Amritsar, DRME, Punjab, India Dr. Priti chaudhary Professor Head, Department of Anatomy, GGSMC, Faridkot, DRME, Punjab, India Dr. Rajesh Kapila Professor, Department of Orthopedics, GMC, Amritsar, DRME, Punjab, India Dr. Rakesh Sharma Professor, Department of Orthopedics, GMC, Amritsar, DRME, Punjab, India Correspondence Dr. Simran Jit singh Senior Resident GMC, Amritsar, DRME, Punjab, India Proximal femoral nail: A boon for peritrochanteric fractures Dr. Kamal Kumar Arora, Dr. Simran Jit singh, Dr. Priti Chaudhary, Dr. Rajesh Kapila and Dr. Rakesh Sharma DOI: https://doi.org/10.22271/ortho.2017.v3.i4l.119 Abstract Expected age of human race has increased, leading to increase in the number of geriatric people with osteoporotic bones and falls associated with them. In 1949, Boyd and Griffin classified fractures in the trochanteric region of femur into four types. Biomechanical studies have shown that intramedullary device with sliding screw is better. Its location & rotational stability provides better load transfer and hence provides biological fixation. This was a prospective study of 25 cases of peritrochanteric fractures of femur evaluated as per Harris Hip score. In our study, 60% of the patients had excellent to good functional score with 40% of patients had fair to poor functional score due to presence of comorbidity or affected by one of the complications mentioned further. In our study, the average Harris Hip Score was 82.12 with the range of 66.5-92.5. Keywords: Peritrochanteric, femur, PFN Introduction Expected age of human race has increased, leading to increase in the number of geriatric people with osteoporotic bones and falls associated with them, which leads to significant increase in the incidence of proximal femur fractures all over the world [1] . Gullberg et al. in 1997 estimated the future incidence of hip fracture worldwide would double to 2.6 million by the year 2025, and 4.5 million by the year 2050. [2] Hagino et al reported a lifetime risk of hip fracture for individual sat 50 years of age as 5.6% for men and 20% for women. [3] These fractures are more common in women perhaps due to many risk factors like wider pelvis in women leading to tendency to coxavara, women being less active develop osteoporosis which is further enhanced by post-menopausal effects on bones. [4] ‘peritrochanteric fractures’ account for more than half of hip fractures caused by a trifling fall on ground. Fractures of Proximal femur carries associated risk of morbidity and mortality, viz deep vein thrombosis, pulmonary thrombo-embolism, decubitus ulcers and renal calculi formation. [5] All these factors leads to a mammoth cost on the health care system. [6, 7] Most (90%) of the proximal femur fractures in elderly occur due to direct trauma and major portion of it is due to a trivial fall. [8] Multiple factors which lead to falling in elderly, are poor vision, decreased reflexes, neurovascular diseases osteoporosis, associated spinal deformities. [9] Falls with a rotational component are more common with extra capsular hip fractures. [10] Two subsets of patients are commonly observed. first group, comprising of older patients who sustain these fractures due to low-energy trauma & due to osteoporotic changes in their bones are sometimes known as fragility fractures. [11] These are also at risk for metastatic secondaries in the hip. Second group, comprising of young patients with normal bone architecture; the majority of injuries are the result of almost always high-energy trauma. The attributed mechanisms include axial compression against the acetabular roof, with hip in flexion and abduction; associated injuries like pelvic and acetabular fractures, spine injuries, are time and again seen when the knee is in an attitude of flexion. Sub-trochanteric fractures also occur in patients exposed to chronic (5 years or greater) or high dose bisphosphonate therapy, usually due to low energy trauma or spontaneous fractures in this patient group have also been reported [12] .