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International Journal of Orthopaedics Sciences 2020; 6(2): 569-571
E-ISSN: 2395-1958
P-ISSN: 2706-6630
IJOS 2020; 6(2): 569-571
© 2020 IJOS
www.orthopaper.com
Received: 22-02-2020
Accepted: 24-03-2020
Dr. Narendra Singh Butola
Junior Resident, Department of
Orthopedics, HIMS, SRHU,
Uttarakhand, India
Dr. Anit KS Deane
Associate Professor, Department
of Orthopedics, HIMS, SRHU,
Uttarakhand, India
Dr. Chetan Peshin
Associate Professor, Department
of Orthopedics, HIMS, SRHU,
Uttarakhand, India
Dr. Faiz Akbar Siddiqui
Assistant Professor, Department
of Orthopedics, HIMS, SRHU,
Uttarakhand, India
Corresponding Author:
Dr. M Krishna Chaitanya
Assistant Professor, Department
of Orthopedics, HIMS, SRHU,
Uttarakhand, India
Study on final neck shaft angle achieved after surgical
correction of pertrochanteric fractures of femur
Dr. Narendra Singh Butola, Dr. Anit KS Deane, Dr. Chetan Peshin and
Dr. Faiz Akbar Siddiqui
DOI: https://doi.org/10.22271/ortho.2020.v6.i2i.2100
Abstract
Introduction: Pertrochanteric fractures are defined as “Fractures occurring in the region extending from
the extracapsular basilar neck region to the region along the lesser trochanter proximal to the
development of medullary canal”. Incidence of pertrochanteric fractures increase with increase in the age
of population and quite often results in the end of patient’s functional independence. Management of
pertrochanteric fracture depends on patient’s medical condition, quality of bone and the fracture
biomechanics. The main goal of this study is to assess and compare the NSA in surgically fixed
pertrochanteric fracture of femur at time of surgical fixation and compare it with final NSA attained at
time of fracture union.
Material & Method: This Observational and prospective study was conducted over a period of 1 year
and includes 100 cases of pertrochanteric fractures with mature skeleton. X-ray of pelvis with both hips
AP view was taken after fixation of fracture using standard protocol. Measurement of NSAs in the
operated hips was done using postoperative digital X - ray films with help of Bersoft image measurement
software trial version 8.49. Data was analyzed for NSA in non-fractured limb and the restoration/change
in NSA in operated hip after surgical fixation and in follow up period.
Result: In our study, the statistical analysis showed that mean NSA after immediate post op was 130.445
± 11.1976, after 6 weeks was 128.586 ± 11.1954 and 127.305 ± 9.9472 at union.
Conclusion: Irrespective of fixation method used (DHS/PFN), NSA significantly changes during first 6
weeks in the post op period and after 6 weeks it remains unaffected and fracture become relatively stable.
Therefore it can be concluded that there is no need to delay mobilization past 6 weeks of surgery.
Keywords: Pertrochanteric, neck shaft angle (NSA)
Introduction
The angle between femur neck and the long axis of shaft is known as neck shaft angle (NSA).
NSA plays vital role in stability, control of lateral balance; walking and hip movements.
Evaluation of NSA of femur is useful in understanding biomechanics of the hip joint. It helps
in the planning of treatment of various affections of hip region and also in designing prosthesis
for this region
[1]
. According to a study on Indian population, average femoral neck length in
adults is approximately 5 cm long and average NSA is approximately 135 degree
[2]
. Different
ethnic groups have different build; physique, habits and genetic makeup, and possibly
anthropometric measurements of proximal femur that are described normal for western
population can differ from the measurements seen amongst Indian population
[3]
.
Material and Methods
This study was carried out in the Department of Orthopedics at Himalayan Institute of Medical
Sciences, Swami Ram Nagar, Dehradun over a period of 12 months. Total 100 cases of
pertrochanteric fractures fulfilling the inclusion criteria are included.
The Exclusion criteria
1. Pertrochanteric fractures in patients with an immature skeleton.
2. Patients with an existing condition affecting NSA e.g. congenital deformity (DDH),
Perthe’s disease, old fracture/ operated cases of neck of femur or intertrochanteric
fracture, infective and neoplastic pathologies etc.