Comparative Analysis of Functional Outcomes: Extramedullary Versus Intramedullary Fixation in Unstable Inter-Trochanteric Femoral Fractures: Extramedullary Versus Intramedullary Fixation

Rasheed Ahmed Bhatti; Ashfaque Hussain Mirjat; Awais Abro; Lachman Das Maheshwari; Agha Mahtab Hussain; Faisal Memon

doi:10.54393/pjhs.v5i06.1736

Authors

Rasheed Ahmed Bhatti Department of Orthopaedic Surgery, Bilawal Medical College for Boys Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Ashfaque Hussain Mirjat Department of Orthopeadic Surgery, Suleiman Roshan Medical College, Tando Adam, Pakistan
Awais Abro Department of Orthopeadic Surgery, Kulsoom Bai Valika Hospital, Karachi, Pakistan
Lachman Das Maheshwari Department of Orthopaedic Surgery and Traumatology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Agha Mahtab Hussain Department of Orthopeadic Surgery, Suleiman Roshan Medical College, Tando Adam, Pakistan
Faisal Memon Department of Orthopaedic Surgery and Traumatology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i06.1736

Abstract

Unstable trochanteric femoral fractures are challenging to manage. Two options exist for the operative treatment and management of unstable trochanteric fractures; i.e. extramedullary or intramedullary stabilization. However, there is a dearth of good evidence of the clinical efficacy of either of the two methods especially in terms of functional outcomes. Objective: To compare the functional outcome following fixation of unstable trochanteric femoral fractures via extramedullary versus intramedullary methods. Methods: This prospective cohort was conducted upon 46 adult patients and admitted at Liaquat University Hospital Hyderabad/Jamshoro, after taking written informed consent from parents. Functional outcomes utilizing the Timed Up and Go Test and Harris Hip Score, at 3 months and 6 months post-surgery and radiographic parameters were gathered to evaluate heterotopic ossification and femoral neck shortening at follow-up visits using a pre-structured questionnaire. The data was analyzed with SPSS V.21 and Microsoft Excel 2016. Results: The sample predominantly consisted of males, with a mean age of 31 ± 5 years. Intramedullary fixation showed superior early mobility outcomes and maintained better hip function scores compared to extramedullary fixation for unstable inter-trochanteric femoral fractures. Intramedullary fixation also demonstrated lower rates of heterotopic ossification and less femoral neck shortening, indicating potential benefits in reducing complications and preserving anatomical integrity. Conclusions: In conclusion, the study findings suggest intramedullary fixation as a favorable option for optimizing functional recovery and radiographic outcomes in such fractures

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