Study of functional outcome of intertrochanteric femur fractures fixed with proximal femoral anti-rotation (PFNA2) nail

Abstract

Introduction: Intertrochanteric fractures are one of the commonly occurring injuries in elderly patients and are high among females and those with osteoporosis. Unstable intertrochanteric femur fractures are treated commonly with intramedullary nails. Newer designs like Proximal Femoral Nail Antirotation-2 have been introduced for Asian population. The aim of our study was to compare the radiological and functional outcome of unstable intertrochanteric femur fracture treated with Proximal Femoral Nail Antirotation-2 nails. Methodology: This study was carried out at Department of Orthopaedics, Tertiary care Hospital. During this period, 36 patients with intertrochanteric femur fractures were identified of which 34 patients were enrolled in the study based on the inclusion and exclusion criteria. With 4 patients being lost to follow-up during the course of study before completing at least 6 months of follow-up, we had 30 patients remaining to study. Results: Harris Hip score was applied to assess outcome. 22(74%) had good to excellent results. 8 (26%) had fair to poor results. However, radiologically none of the patients had poor results. We cannot readily rule out objective bias in our radiological assessment. Conclusion: Early surgery on patients with trochanteric fractures improved its ability to return to independent living and complications of prolonged immobilization are prevented. PFNA2 has advantages like less surgical time for fixation, less fluoroscopy time, optimum for small neck, less blood loss and it is better suited for Asian population.