Abstract: Introduction: Fractures in sub-trochanteric regions are common in elder as well as younger population though force of injury varies. In younger age this results from high velocity trauma around hip while in elder population this may occur due to trivial trauma like simple fall. This type of fracture constitutes 10-30% of fractures around hip. Usually these type of fractures result in poor outcome because of difficult reduction due to muscle forces across fracture, comminution of fracture fragments and factors like osteoporosis. Treatment includes fixation of this fracture using various intramedullary as well as extra medullary side support implants. Proximal femoral nail is most commonly used implant as they share the load across the fracture. This type of fracture is having a very high failure rate resulting in non-union or varus mal-union with implant failure. The forces across the fracture are well countered by combining intramedullary as well side support implants. In this study we used Ender’s Nails as intramedullary implant and with 4.5 mm Dynamic compression plate and 4.5mm and 6.5 mm screws as extra medullary implant that adds the rotational stability to bone implant construct.
Materials and methods: 25 patients operated from June 2015 to December 2019 were identified from the available records and included in the study. All the treatment documents of selected patients till their last follow-up were reviewed. During their last follow-up Harris Hip Score was counted and Tegner Activity scores were obtained.
Results: Out of 25, 18 were Male and 7 were female patients. Mean age of patients was 43. Most common mode of injury was road traffic accident. Fracture was united in all the patients (Union rate was 100%). 2 patients developed minor complication like nail backing out at knee joint. Harris Hip Scores is excellent in 20(80%) and good in 5(20%) numbers of patients. None of the patients were having movement restriction for hip and knee joint of the affected side.
Conclusion: Combination of intra medullary device like Ender’s nail and extra medullary implant like Dynamic compression plate for sub-trochanteric fracture is having good functional results and they are beneficial in terms of cost of the implants and technical ease.
