Online ISSN: 2515-8260

Keywords : PFNA2

A Prospective Study in the Management of Peritrochanteric Fractures Femur by PFNA2

Shameer Ismail, Anwar Hamzath A K, Ravi Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2283-2298

Background and Objectives
Intertrochanteric fracture is one of the most common fractures of the especially in the elderly with osteoporotic bones usually due to low energy trauma like simple falls. Internal fixation is appropriate for most intertrochanteric fractures.  Optimal fixation is based on the stability of the fracture. PFNA2 is biomechanically considered one of the most effective methods of treatment with promising results.
Methods: This is a prospective study of 30 cases of fresh trochanteric and subtrochanteric fractures admitted to DMMC Wayanad between June 2019 to June 2022. Cases were taken according to inclusion and exclusion criteria i.e., patients with Peritrochanteric fracture above the age of 18yrs. Medically unsuitable and patients not willing for surgery were excluded from the study.
Results: In our series of 30 cases there were 18 males and 12 females, maximum age of 94 yrs and minimum age of 22 yrs, most of the patients were between 41 to 60 yrs. Mean age of 55.18 yrs. 45% of cases were admitted due to slip and fall and with predominance of right side. Out of 30 cases, 22 were trochanteric and 8 were subtrochanteric. In Trochanteric class 50% were Boyd and Griffin type 2 33.33% were of type 3, in Subtrochanteric class 37.5% were Seinsheimer’s type 3a and 25% were 3b. Mean duration of hospital stay is 20.67 days and mean time of full weight bearing is 16.5 wks. Good to excellent results were seen in 91.66% cases of trochanteric fractures and 87.5% cases in subtrochanteric fractures.
Conclusion: Proximal femoral nail antirotation in Peritrochanteric fracture is a good method of fixation.  The procedure is easy with reduced operative time and radiation exposure. So we strongly recommend PFNA2 for fixation of Peritrochanteric fracture of hip.

A comparative study of 30 cases of intertrochanteric fracture femur in elderly patients treated with Proximal Femoral Nailing Anti Rotation-2(PFNA-2) and Proximal Femoral Nailing (PFN)

Dr.ManjitSingh, Dr.DilmohanSingh Karday,Dr. DharminderSingh

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3189-3196

Increased life expectancy has led to a considerably increased incidence of proximal femoral
fractures. The standard of peritrochanteric fracture treatment is stable fixation, which allows
early full weight-bearing mobilization of the patient. A prospective, observational and
randomized study was carried out with a total of thirty patients with intertrochanteric femur
fractures admitted in Govt. Medical College and Rajindra Hospital Patiala after fulfilling the
inclusion criteria and were treated with osteosynthesis with proximal femoral nailing antirotation-
2 (PFNA-2) and proximal femoral nailing (PFN) after dividing them into two groups
randomly i.e. Group A and Group B with 15 cases in each. Harris Hip Score was used as criteria
for evaluation of results and functional outcome was graded accordingly. The authors conclude
that PFNA2 gives better results than PFN in intertrochanteric fractures in terms of the amount of
blood loss during surgery, duration of surgery, postoperative complications. However, there is no
difference between the two modalities in terms of duration of hospitalization, fracture union, and
early rehabilitation (mortality and morbidity).

Short Proximal Femoral Nail A2 Vs Long Proximal Femoral Nail A2 For The Management of Intertrochanteric Fractures in Elderly

Dr.Santosh Kumar Sahu; Dr.Abhishek Pandey

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 6, Pages 1144-1149

Background: Elderly hip fractures are a very frequent orthopaedic issue.Although varioustreatment methods have been suggested in past for the management of intertrochanteric fractures in geriatric population,itstill emainscontroversial as regards the treatment of choice to manage these fractures . The current study demonstrates the efficacy of proximal femur-intramedullary nail antirotation (PFNA2) of Asia inmanaging fractures of inertrochanteric.Our study will be based upon the comparision of effectiveness and shortcomings we encounter while using short proximal femoral nailA2vs long femoral nailA2 for managing fractures of intertrochanteric.Methods& Materials:The above research has beendone at IMS and SUM hospital between November 2016 to November 2019. 87 individuals having fracturesare chosen.Group-a had 45 patients treated with short PFNA2,group-bhad 42 patients,whowere treated with long PFNA2.All fractures were classified as per Orthopedic Trauma Association(OTA) AS 31A1,31A2,31A3.All the patients were evaluated on immediate post-operatively, 1st, 3rd, 6th and 12th month using Harris hip score.
Results:Current study shows that the frequently occurring fracture modes is trivial traumafollowed by fall, which was observed within 58 out of 88 cases,which comes out to be 65.5% of reason behind the fracture. Average operative loss of blood was 226.5ml withinPFNA2group,whereas it was 124.5ml in the short PFNA2group.The factor regarding union was better in the short PFNA2(10.2weeks)than the long PFNA2 group(20.1weeks).However,limb shortening was found to be more in the short PFNA2 as against the long PFNA2.Anterior femoral canal impingement was found to be more with long PFNA2(5 cases)compared to short PFNA2(1case).
Conclusion:Observing the above findings for method of managing trochanteric fractures ,short PFNA2 emerges as a better choice vs long PFNA2,if proper preop planning is used leading to less soft tissue damage and as a result high rate of union,especially in the Asian population who have a small femur.