Pre fixation compression screw as a cutting-edge technique for varus correction during proximal femoral nailing for intertrochanteric fractures: A study on 46 cases

Abstract

Background: Achieving reduction prior to fixation is a key aspect in successfully managing intertrochanteric fractures. In this study of proximal femoral nailing for intertrochanteric fractures, a novel technique of utilizing pre-fixation compression screw was introduced to achieve and maintain reduction of femoral neck shaft angle. Materials and Methods: The current prospective study was conducted over a period of six months between July 2018 and January 2019 among patients who underwent surgical fixation by PFN for intertrochanteric fractures of femur. Pre-fixation compression screw was used in all the cases to achieve and maintain correction of varus. Pre-operative, intra-operative and post-operative neck shaft angles were documented. Data was analysed by using Statistical Package for Social Sciences (SPSS). The results were expressed as percentages and graphs. Results: There is significant improvement in correction of varus (average increase of neck shaft angle =14.04 degrees) with the use of pre-fixation screw technique. This procedure did neither increase the blood loss (average blood loss = 34.67 ml) during the procedure nor the duration (average duration = 19.46 min) of the procedure. Conclusion: Pre-fixation compression screw can be used as an effective alternative for varus correction in cases of simple intertrochanteric fractures undergoing PFN fixation with added intra-op and post-op advantages compared to other methods of reduction.