An outcome analysis of intertrochanteric fracture of femur managed with proximal femoral nail antirotation II

Hemeshwar Harshwardhan, Shubhanshu Jain, Manish Sharma


Background: Intertrochanteric fractures are common osteoporotic fractures in adults above 60 years with high mortality and morbidity. Common techniques for fixation of these fractures are sliding hip screw and plate or intramedullary nailing. Intramedullary nailing has advantage of short incision, less operative time, rapid rehabilition & thus decreased medical complications. PFNA II is newer intramedullary implant developed to obtain better fixation strength in osteoporotic bones. Biomechanical studies has demonstrated that PFNA II blade has a significance of higher cut out resistance than other commonly used screw systems.

Methods: Prospective follow up study carried out at J.L.N. Medical College Ajmer from 1 March 2017 to 31st October 2018. 30 patients with unstable intertrochanteric fractures were included and operated on fracture table in supine position with PFNA2. We measured operative time, duration of hospital stay, modified Harris hip score and complications.

Results: The mean age of the patients was 70.83 years of age. The mean time in surgery was 38.2 minutes. The mean amount of blood loss in surgery was 110.8 ml. In implant related complications, 2 patients had cut out and 1 patient had pull - out of the implant. Functional results according to modified Harris hip scores was found to be excellent in 8 (30%) patients, good in 12 (40%) patients, fair in 7 (20%) patients and poor in 3 (10%) patients.

Conclusions: Elderly patients treated with PFNA2 has good outcome as less operative time, minimal blood loss, early weight bearing, less union time and very few cases of medial penetration and back out of spiral blade. 


Intertrochanteric, Intramedullary, PFNA II, Nailing

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