Functional outcome of proximal femoral nailing Antirotation (PFN-A) in intertrochanteric fractures: A prospective study

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Abstract
Introduction: The study was conducted to assess clinical and functional outcome of Proximal Femoral nailing antirotation in intertrochanteric fractures and to determine the rate of union, complications, operative risks and co morbidities associated with intertrochanteric fractures. Intertrochanteric fractures form around half of the total hip fractures in the elderly and pose a number of management dilemmas depending on the fracture configuration and status of the bones. There are numerous implants available for the internal fixation of these fractures ranging from dynamic hip screw which can be combined with trochanteric stabilisation plate; locking plates; intramedullary implants such as proximal femoral nail (PFN), trochanteric femoral nail (TFN) and Gamma nail.Materials and Methods: The fractures were classified according to BOYD and GRIFFIN classification system. 40 patients of intertrochanteric fractures fulfilling the inclusion and exclusion criteria, were managed surgically using Proximal Femoral Nail A. The results were analyzed according to age, type of fracture, operative details and functional outcome using KYLE’s criteria.Results: Totally 40 patients with intertrochanteric fractures were operated with PFNA and were included in the study. The mean age of the patients was around 64 years with minimum age being 52 years and the maximum being 88 years. The mean duration of operation was recorded to be 49.59 min. Complications in this study were seen in 2 patients (5%), Complication was surgical site infection. Conclusion: Our study suggests that the PFNA is a better implant in elderly patients with severe osteoporosis as there is the shorter operating time and easier placement of the helical blade and also allows for early mobilization. The main benefits being the shorter surgical time and the decreased need for fluoroscopy. It has a excellent functional outcome and least least failure rates.