Comparative Study between Proximal Femoral Nail and Proximal Nail Antirotation Unstable Trochanteric Fractures in Andhra Population

Abstract

Background: Intertrochanteric fractures are quite common in elderly patients. Although many devices are present
to stabilize the fractures for early healing hence early healing, Ideal techniques are required because in old age
bones are osteoporotic.
Method: 70 (seventy) patients aged between 50 to 70 years admitted due to intertrochanteric fracture were studied.
35 patients were inserted with proximal Femoral Nail (PFN) and 35 were inserted with proximal Nail anti rotation
(PENA). The helical blade PFN has two screws, one large which stabilizes the fractured part of femur and another
is anti-rotation while PFNA has helical blade which provides stability and anti-rotation mobility. Both surgeries
were similar but instrumentations and techniques were different.
Results: The mean duration time for PFN was 40.30 (±6.11) and 35.19 (±5.03) in PFNA, t test was 3.82 and p<0.004.
Blood loss was 75.76 (±14.33) in PFN 59.39 (±11.98) in PFNA, t test 5.18 and p<0.001 Fluoroscopy images mean
value 27.48 (±3.44) in PFN, 16.28 (±3.11) in PFNA, t test 14.2 and p<0.001. Reoperation was 3 (8.57) in PFN and 1
(2.85%) in PFNA. Cut out z-effect was 4 (11.4%) in PFN and 1 (2.85%) in PFNA, loss of reduction had shortening
>1 cm were 6 (17.1%) in PFN and 3 (8.57%) in PFNA. Varus malalignment was 4 )11.4%) in PFN and 1 (2.85%) in
PFNA. Postoperative final outcomes were very less in PFNA as compared to PFN surgery.
Conclusion: PFNA technique significantly reduced duration of time for surgery, loss of blood,
fluoroscopy imaging usage mortality rate hence PFNA is a better option is Osteoporotic (elderly) patients.