Prevalence of Rotational Malalignment Following Cephalo-Medullary Nailing in Inter-Trochanteric Fractures (Code-T0063)

Introduction: Inter-trochanteric fractures are common in elderly patients, and their management often involves cephalo-medullary nailing. While this technique has proven effective in stabilizing the fracture, rotational malalignment remains a concern and can lead to poor functional outcomes. This study aims to determine the prevalence of rotational malalignment following cephalo-medullary nailing in inter-trochanteric fractures.

Aims and Objectives:

1. To study the prevalance and degree of rotational malalignment after cephalomedullary nailing for intertrochanteric fractures.
2. To assess the effect of rotational malalignment on functional outcome.

Methods: This retrospective study included 100 patients who underwent cephalo-medullary nailing for inter-trochanteric fractures. Postoperative radiographs were analyzed for rotational alignment, comparing the affected limb with the uninjured side. The degree of rotational malalignment was classified into mild, moderate, and severe. Clinical outcomes, including pain, functional mobility, and the range of motion, were also assessed.

Results: Rotational malalignment was observed in 30% of patients, with 15% experiencing moderate to severe malalignment. The majority of cases (70%) had mild rotational malalignment, which did not significantly affect clinical outcomes. However, moderate to severe malalignment was associated with poorer functional scores and increased pain levels, particularly in activities involving gait and hip motion.

Conclusion: Rotational malalignment following cephalo-medullary nailing is common in inter-trochanteric fractures, though its clinical impact varies. Mild malalignment may not significantly affect outcomes, but moderate to severe malalignment can lead to functional impairment. Early detection and correction are crucial for optimizing patient recovery.

Keywords: Rotational malalignment, Cephalo-medullary nailing, Inter-trochanteric fractures, Hip fractures, Functional outcomes, Orthopedic surgery.