Comparison of Functional and Radiological Outcome of Inter-Trochanteric Femur Fracture Treated with Using Conventional Proximal Femoral Nail Vs Helical Blade Anti-Rotation Proximal Femoral Nail (PFNA2) in Elderly Patients

Abstract

Background: The aim of this study is to compare the twin screw derotation type and the helical blade type of implants, in intertrochanteric fractures in a tertiary-level centre.

Methods: 48 patients with intertrochanteric fractures were operated with either standard proximal femoral nail (PFN) or proximal femoral nail anti-rotation (PFNA2) after randomly segregating them. Demographics, various operative parameters, outcome parameters, and complications were assessed. Osteoporosis treatment was provided to all patients.

Results: The mean follow-up was 6 months. The hospital stay and Harris hip score were similar in both groups, however the radiation exposure, surgical time, and blood loss were significantly less in the case of PFNA2.

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 guide-wire 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.