Comparative study of treatment of intertrochanteric femur fractures by proximal femoral nail(PFN) and proximal femoral nail-antiroation(PFN-A)

Dr Manjeet Singh; Dr Ashwami Ummat; Dr Alambeer Singh; Dr Sarthak Sharma

Volume : IX, Issue : I, January - 2019

Comparative study of treatment of intertrochanteric femur fractures by proximal femoral nail(PFN) and proximal femoral nail-antiroation(PFN-A)

Dr Manjeet Singh, Dr Ashwami Ummat, Dr Alambeer Singh, Dr Sarthak Sharma

Abstract :

Introduction: Proximal femoral fractures are a big challenge in traumatology both for orthopaedic surgeons and anaesthetists. Proximal femoral fractures include the intracapsular and extracapsular fractures. Pertrochanteric, intertrochanteric and subtrochanteric fractures are extracapsular fractures. The present study was aimed to compare the results of surgical management of Inter–trochanteric femoral fractures treated by Proximal Femoral Nail(PFN) and Proximal Femoral Nail Antirotation (PFN–A) as regards to Fracture union in terms of radiological outcome and functional restoration and to study the complications and their mana. The present study was conducted on 30 adult patients (both male and female above the age of 50 years) with Intertrochanteric femoral fractures attending the Out Patient Department/Emergency of the Department of Orthopedics, MMIMSR. 15 Patients each were randomly selected for PFN and PFN–A fixation. The functional outcomes achieved after treatment of unstable intertrochanteric fractures with both PFN and PFNA are satisfactory and comparable. The PFNA is an easier implant to insert owing to a single device for proximal fixation, which translates into lesser surgical time as compared to the PFN. The number of implant related complications encountered with the helical blade are lesser than that with the PFN. This can be attributed to the biomechanically superior hold of the helical blade by virtue of compaction of cancellous bone around it. Irrespective of the implant used, the quality of reduction achieved intra–operatively is the major determinant of success of fracture fixation. Functional outcomes after intertrochanteric fractures especially in the elderly are only in part dependent on the implant and fracture union. Age, general debility and pre injury functional status are also major determinants of post operative outcome.