Comparison of proximal femoral nail antirotation and proximal femoral nail antirotation-II in treatment of femur intertrochanteric fracture

Abstract

Objective To compare the clinical effects of proximal femoral nail antirotation (PFNA) and proximal femoral nail antirotation-Ⅱ (PFNA-Ⅱ) in the internal fixation of femoral intertrochanteric fracture. Methods A retrospective study was conducted of the 54 patients with femoral intertrochanteric fracture who had been treated at our department from May 2009 through July 2014. During May 2009 and November 2011, 27 of them were treated with PFNA; during December 2011 and July 2014, the other 27 of them were treated with PFNA -Ⅱ. The 2 groups were compared in terms of operation time, intraoperative blood loss volume, hidden blood loss volume, intraoperative and postoperative complications, fracture healing time and Harris hip score at the last follow-up. Results In the PFNA group, 27 patients were followed up for an average time of 22.6±4.8 months. In the PFNA-Ⅱ group, 27 patients were followed up for an average time of 19.5±4.6 months. The PFNA group had significantly more intraoperative blood loss volume (130.1±74.3 mL), and significantly higher rates of intraoperative lateral wall fracture of the proximal femur (18.5%, 5/27), postoperative lateral thigh soft tissue irritation (22.2%, 6/27) and postoperative thigh pain (22.2%, 6/27) than the PFNA-Ⅱ group [46.3±23.1 mL, 0, 3.7% (1/27), 3.7% (1/27), respectively] (P 0.05). Conclusion Compared with PFNA, PFNA-Ⅱ may lead to a smaller volume of intraoperative blood loss and a lower incidence of complications related to internal fixation. Key words: Hip fractures; Fracture fixation, intramedullary; Bone nails