Comparison of Twin Screw Derotation Type Versus Single Helical Blade Type Cephalomedullary Nail in Trochanteric Fractures in Geriatric Population.

Abstract

Introduction The aim of this study was to compare the usage of two devices, the twin screw derotation typeand the helical blade type, in intertrochanteric fractures in the geriatric population at a tertiary-level center. Methods Forty-six eligible patients with intertrochanteric fractures operated with the standard proximal femoral nail (PFN) or proximal femoral nail anti-rotation (PFNA2) were included for analysis. This was a retrospective analysis of prospectively collected data over the study period. Demographics, various operative parameters, outcome parameters, and complications were assessed. Medical management of osteoporosis was provided to all patients. The student t-test and chi-square test were used with SPSS V22.0 (IBM Corp., Armonk, NY) for statistical analysis. Results The mean follow-up was 14 months. The hospital stay and Harris hip score were similar in both groups, but the radiation exposure, surgical time, and blood loss were significantly less in the case of PFNA2. Screw cut-out was also not observed in our study. Conclusion Both PFNA2 and PFN are effective in treating unstable trochanteric fractures in terms of functional outcomes. However, PFNA2 is better because it requires less radiation exposure (p<0.05) due to single guidewire use, a short learning curve, less blood loss, shorter surgical time(p<0.05), and fewer complications. We suggest it to be the preferred implant in trochanteric fractures in the geriatric population and other age groups.