Functional and radiological outcomes of atypical femur fractures among elderly in Karachi, Pakistan

Objective: To assess the functional and radiological outcomes in a unique class of fractures i.e. atypical femur fractures and to assess the effects of osteoblastic agents in healing. Methods: It is a retrospective observational study conducted at Aga Khan University Hospital, Karachi, Pakistan. All patients with atypical femur fractures who were surgically managed with intramedullary nailing from January, 2013 to June, 2017 and with a follow-up till December 2019, were included in the study. Radiological outcomes were expressed as mean healing time and functional outcomes were recorded as mean Short Musculoskeletal Functional Assessment (SMFA) score. Results: A total of twenty-four patients were included in this study. Mean age of patients was 65.8 ± 8 years. Mean healing time was 10 ±3.2 months post operatively. Two patients underwent redo procedures. No other complications like paresthesia or weakness was observed in any patients. All the patients reported a good score on SMFA ranging from 19% to 31%. Conclusion: Intra-medullary nailing shows a promising result in treatment of atypical femur fractures. Use of postoperative osteoblastic supplements showed statistically significant results with early healing time (p=0.008 [95% CI]).