Clinical Effects of Working Length of Cephalomedullary Nails in Pertrochanteric Femur Fractures: A Case Series of 30 Patients.

INTRODUCTION

Pertrochanteric femur fractures are common in elderly patients with osteoporosis. Cephalomedullary nails are the standard of care, but the choice between short and long proximal femoral nails (PFNs) remains debated.

MATERIALS AND

METHODS

We present a case series of 30 patients with pertrochanteric fractures treated at our institute between January 2023 and December 2024. Fifteen patients were managed with short PFN and fifteen with long PFN. Functional and radiological outcomes were assessed using Harris hip score, time to union, complication rate, and post-operative mobilization. Long PFNs showed faster union (14.6 ± 1.4 weeks vs. 16.3 ± 1.7 weeks), earlier mobilization, and fewer complications (20% vs. 46.7%). Short PFNs had shorter operative times and lower intraoperative blood loss. Illustrative cases are presented, including implant failures requiring salvage with total hip replacement.

CONCLUSION

Short PFNs are adequate for stable pertrochanteric fractures, but long PFNs provide superior stability and fewer complications in unstable patterns.