Comparative Functional Outcome of Positive versus Neutral Reduction in Intertrochanteric Femur Fractures Treated with Cephalomedullary Nails: A Prospective Study

Karthik Sagar S; Mahadev Gowda Prakhyath; Parveez Ahmed Syed; Likhith Kumar L

doi:10.37022/wjcmpr.v8i2.410

Authors

Karthik Sagar S Senior Resident, Department of Orthopedics, Bangalore Medical College and Research Institute, Bengaluru.
Prakhyath Mahadev Gowda Senior Resident, Department of Orthopedics, Bangalore Medical College and Research Institute, Bengaluru.
Syed Parveez Ahmed Fellow in Arthroplasty, Department of Orthopedics, BMCRI, Bengaluru.
Likhith Kumar L Fellow in Arthroplasty, Department of Orthopedics, Bangalore Medical College and Research Institute, Bengaluru.

Abstract

Background: Reduction quality is a critical determinant of outcome in intertrochanteric fractures. Positive medial cortical support (PMCS) has been proposed to improve stability and reduce complications. Methods: A prospective comparative study of 60 patients (30 positive reduction, 30 neutral reduction). Functional outcomes assessed using VAS and mHHS at 2 weeks, 6 weeks, 3 months, 6 months, and 9 months. Results: Both groups showed significant improvement over time (p < 0.001). No statistically significant difference between groups was observed. A trend toward better early function in the positive group was noted. Conclusion: Positive medial cortical support does not significantly improve functional outcomes compared to neutral reduction. Both techniques provide comparable results when stable fixation is achieved.

Keywords:

Intertrochanteric femur fracture, Positive medial cortical support, Neutral reduction, Cephalomedullary nail, Modified Harris Hip Score, Tip-apex distance (TAD)

DOI

https://doi.org/10.37022/wjcmpr.v8i2.410

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