IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-8-3-18505 Original Research Paper A PROSPECTIVE STUDY ON OUTCOME OF CLOSED SUBTROCHANTERIC FRACTURE MANAGEMENT KARTHIK RAJA Dr. March 2019 8 3 01 02 ABSTRACT

Subtrochanteric femur fractures have demanded special consideration in Orthopaedic Traumatology, given the higher rate of complications associated with their management. The purpose of the study is to evaluate the functional outcome of closed subtrochanteric fractures managed surgically in Government Royapettah Hospital/Kilpauk Medical College, Chennai A total of 20 patients were taken up for the study. 10 patients were treated with reconstruction Nail, 10 patients were treated with Dynamic Condylar Screw fixation. Primary bone grafting was done in 4 patients who were treated by open reduction for Seinsheimer type IV and V On follow up patients were assessed by traumatic hip score by Sander’s et al.,. Out of 20 cases there were 3 cases (15%) of malunion. One patient in recon nail group and two in DCS group. Many patients have occasional pain. Most of them walk without support. Mostly do their normal activities. Almost all patients have normal muscle power.Nonunion was noted among 3 patients. One in recon nail group and two among DCS group. One failure case in DCS group was due to implant failure secondary to infection for which Implant removal was done and infection control achieved. This study suggests that reconstruction nail is a reliable implant for subtrochanteric fractures, leading to high rate of bone union and minimal soft tissue damage. Intramedullary fixation has biological and biomechanical advantages. Reconstruction nail being a load sharing device, rehabilitation can be started early, DCS fixation being load bearing device may be unstable in fractures with posteromedial communition, delaying rehabilitation.