A33 Report of early results of the use of PFNA II in the treatment of peritrochanteric fractures

Abstract

Aim: Compared to PFNA, PFNA II is considered to be more anatomic due to the smaller proximal diameter, the lateral flattened crosssection and the 5° medial-lateral angle it possesses. We undertook this study to assess whether these characteristics lead to: 1) Easier insertion of the nail, 2) Retainment of the reduction after the insertion, 3) Reduced pressure to the lateral cortex, 4) A final position of the nail in the center of the medullary cavity. Material & Methods: During the period from November 2009 until August 2010, 50 consecutive patients underwent intramedullary nailing with PFNA II, after suffering a peritrochanteric fracture. There were no exclusion criteria. The patients were evaluated clinically and radiographically immediately postoperatively, 6 weeks, 3 months, 6 months and 1 year after surgery. The mean time of follow-up was 7.7 months. Results: In 41 cases (82%) the insertion of the nail was considered to be easier. In 47 cases (94%), the initially achieved reduction was retained. Furthermore, the distance between PFNA II and the lateral cortex was considered to be enough in 46 cases (92%). Finally, the intramedullary position of the nail was at the center in 37 cases (74%), whereas in one case (2%) it was eccentric at the frontal and at the saggital plane. Concerning the follow-up of the patients, no complication related to the nail was observed. In one case, delayed union was observed. Conclusions: Given these findings, PFNA II can successfully be used in any case of patient presenting with a peritrochanteric fracture, as: 1) The operating time is reduced due to its easier insertion, 2) The rate of complications is reduced due to its new characteristics in total.