Clinical and functional outcome of intertrochanteric femur fractures treated using PFNA2 in patients with osteoporosis
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 2361-2368
Background: Intertrochanteric femur fractures are one of the most common fractures around hip in elderly population. These fractures are commonly treated with intramedullary nailing. Different designs of intramedullary nails are available. Proximal Femoral Nail Anti-rotation 2 is a newer nail design introduced for Asian population. Aim of this study is to analyse clinical and functional outcome of intertrochanteric femur fractures treated with PFNA2 in patients with osteoporosis.
Materials and Methods: Patients presenting with Intertrochanteric fractures, less than 2 weeks old, with Singh’s Index </= 3 were included in the study. Quality of reduction was assessed using neck shaft angle, tip apex distance and Cleveland index in postoperative radiographs. The duration of surgery, number of fluoroscopy images taken, intraoperative blood loss and duration of hospital stay were noted. Patients were followed-up for 6 months. Functional outcome was assessed using modified Harris hip score.
Result: Twenty-three patients with intertrochanteric femur fracture were treated PFNA2. Thirteen patients had neck-shaft angle difference <5o between operated side and normal side. Five patients had tip apex distance of >25mm. The average modified Harris hip score was 90.52. Overall, three complications were seen in this study.
Conclusion: PFNA2 is safe and effective fixation implant in the treatment of intertrochanteric femur fracture in Indian patients due to less blood loss, less intraoperative complications, minimal soft tissue damage and good union rate. Good functional outcome can be achieved once radiological parameters are restored, i.e., neck-shaft angle difference <5o, TAD<25mm and Cleveland index in centre-centre position.
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