European Journal of Molecular & Clinical Medicine

Abstract

Background: Aging is an undefiable process and as the population ages, the incidence of hip fracture is
anticipated to increase exponentially. Prolonged bed rest further worsens the morbidity and mortality
after a hip fracture. Intertrochanteric femur fracture management in elderly needs more attention to
reduce malunion and increase early mobilisation to reduce mortality and morbidity. Ideal choice of
treatment is internal fixation by intramedullary or extra medullary devices. Intramedullary devices
provide more stable proximal femoral anatomical fixation. Between PFN and PFNA; helical blade in
PFAN provides more stability, better compression and rotational control with lower cut-out rate.
Aims and Observations
a) To assess the factors for functional outcome of PFNA2.
b) Evaluation of effectiveness and stability of PFNA2.
Material and Methods: In our study, we have taken 32 patients with unstable Intertrochanteric femur
fracture between Nov 2020 to Oct 2021 fulfilling inclusion and exclusion criteria were included in this
study and underwent closed reduction and internal fixation by PFNA (n=32). Assessment was done in
terms of demography, preoperative and intraoperative variables, postoperative parameters mainly
functional outcome till 1 year postoperative.
Results: In our study Preoperative variables, AO fracture type were assessed preoperatively. Duration
of surgery, blood loss and fluoroscopy imaging were significantly lower in PFNA as compared to PFN.
Postoperative complications like cut-out rate, shortening, varus malalignment, return to pre-fracture state
were also lower in PFNA group than PFN. Postoperative functional assessment done by Harris Hip Score
shows better outcome in PFNA than other fixation devices.
Conclusion: PFNA reduces duration of surgery, blood loss, fluoroscopy imaging as compared to other
implants. PFNA also offers better postoperative functional outcome.