Role of proximal femoral nail anti-rotation in extracapsular proximal femoral fractures

Abstract

Background: Peritrochanteric fractures are devastating injuries involving young and adult population and needs surgical fixation. But there are many complications related to fixation devices & quality of bone. In view of this surgical management of peritrochanteric fractures by other better device is taken up. Material & Method: Twenty five patients with peritrochanteric fracture were included as per inclusion & exclusion criteria. Radiographic & functional outcomes of PFNA II along with its intra & post- operative complications is evaluated. Result: Out of 25 cases there were 13 males and 12 females with age ranging from 22- 95 yrs. Mean duration of hospital stay, operative time & blood loss was 6.28±3.4 days, 54.60±11.71 min & 102.80±15.41 ml respectively. Radiologically ideal implant position in 88% cases & good/ acceptable reduction in 92 % patients was achieved. Good to excellent functional results of operated hip were seen in 62 % cases of peritrochanteric fractures. Intraoperative complications like fracture of lateral cortex & greater trochanter along with fixation of fracture in varus angulation in one case & failure to get anatomical reduction resulting in varus angulation in other case. Postoperatively two patients had deep vein thrombosis & two patients had shortening >4 CMS. Conclusion: PFNA II is very effective & good fixation implant for unstable peritrochanteric fractures.