Assessment of factors resulting to functional outcome of intertrochanteric fracture of femur managed by proximal femoral nail: Antirotation 2 (PFNA 2)

Abstract

Background: Intertrochanteric femur fracture management in elderly needs more attention to reduce malunion and increase early mobilisation to reduce mortality and morbidity. Ideal choice of treatment is internal fixation by intramedullary or extramedullary devices. Intramedullary devices provide more stable proximal femoral anatomical fixation. Between PFN and PFNA; helical blade in PFAN provides more stability, better compression and rotational control with lower cut-out rate. Aim: a) To assess the factors for functional outcome of PFNA2. b) Evaluation of effectiveness and stability of PFNA 2. Material and Methods: 30 patients with unstable Intertrochanteric femur fracture between Nov 2020 to July 2021 fulfilling inclusion and exclusion criteria were included in this study and underwent closed reduction and intermal fixation by PFNA(n=30). Assessment was done in terms of demography, preoperative and intraoperative variables, postoperative parameters mainly functional outcome till 1 year postoperative. Results: Preoperative variables, AO fracture type were assessed preoperatively. Duration of surgery, blood loss and fluoroscopy imaging were significantly lower in PFNA as compared to PFN. Postoperative complications like cut-out rate, shortening, varus malalignment, return to pre-fracture state were also lower in PFNA group than PFN. Postoperative functional assessment done by Harris Hip Score shows better outcome in PFNA than other fixation devices. Conclusion: PFNA reduces duration of surgery, blood loss, fluoroscopy imaging as compared to other implants. PFNA also offers better postoperative functional outcome.