Abstract:
Background
Unstable, comminuted intertrochanteric fractures continue to pose a challenge
to the orthopedic surgeon because of severe osteoporosis and medical disorders that
increase the risks associated with surgery and anesthesia. For treatment of these
unstable intertrochanteric fractures, PFNA was designed by AO in 2004. To overcome
problems like lateral wall impingement and prominence of the proximal end of the
nail, the PFNA-II was introduced in 2008. The PFNA II design modifications include
the flat lateral shape of the proximal portion and a decrease in the mediolateral
bending angle from 60to 50.The purpose of the study is to confirm that the PFNA II
eliminates the problem of lateral wall impingement experienced with previous
intramedullary nailing systems and provides stable fracture fixation with positive
functional outcome.
Aim
To evaluate the functional and radiological outcome of unstable
intertrochanteric fracture, treated PFNA-II in our population.
Materials and methods
This study is conducted between 1st November 2018- 31st may 2020 among 32
patients who were diagnosed with unstable intertrochanteric fracture of femur and
underwent closed reduction internal fixation with proximal femoral nail antirotation
system II. All patients were followed up for minimum of 6 months. Functional
outcome was assessed with modified haris hip score and radiological outcome was
assessed with TAD score and implant related complications.
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Results
Fracture union was appreciated on an average 4 months of postoperative
period.4 patient had superficial infection while 1 patient had deep infection. Only 1
patient had cut off of helical blade. According to modified harris hip score, excellent
outcome in 37.5% patient, good outcome in 43.8% patients, fair outcome in 12.5%
patients, poor in 6.3 cases was noted.
Conclusion
From our study, we have come to the conclusion that PFNA II is a reliable
implant for treatment of unstable intertrochanteric fractures leading to high rate of
union restoring the anatomical alignment and reduced chance of implant failure
