A Comparative Study of Unstable Intertrochanteric Fracture by Proximal Femoral Nail versus Proximal Femoral Nail Anti-Rotation among Adult Patients

Abstract

Objective: To compare unstable intertrochanteric fracture by proximal femoral nail versus proximal femoral nail anti-rotation among adult patients. Methods: This was a comparative study. Patients were randomized into 2 groups: Proximal Femoral Nail Anti-rotation (n=30) and Proximal femoral nail group (n=30). Singh’s index was used to grade the radiographs for the degree of osteoporosis. Functional evaluation was done at 3 months, 6 months, 9 months and 12 months by using Harris Hip Score. Results: Majority of patients in both PFN (60%) and PFNA (70%) were between 61-70 years. More than half of patients of PFN (56.7%) and 43.3% of PFNA were males. The operative time was 84.00±9.39 minutes among patients of PFN and 61.03±5.75 minutes among patients of PFNA with significant difference between the groups. Singh’s grade III was most common among patients of both PFN (36.7%) and PFNA (36.7%). There was no significant (p>0.05) difference in Harris Hip score between the groups at all the time periods. Excellent outcome was in 63.3% patients of PFNA and in 46.7% patients of PFNA. Good outcome was in 33.3% patients of PFN and in 10% of PFNA. Conclusion: The study suggests that both PFN and PFNA perform well, showing equally good functional outcomes following fixation of unstable trochanteric fractures. PFNA offers no significant benefits over PFN in terms of post-operative complications. Keywords: Unstable intertrochanteric fracture, Proximal femoral nail, Proximal femoral nail anti-rotation.