Management And Outcome Of Unstable Intertrochanteric Fracture By Proximal Femoral Nail Versus Proximal Femoral Nail Antirotation In Elderly Patients: A Prospective Comparative Study

Vol 35 | Issue 3 | September-December 2020 | page: 15-20 | Nishant Gandhi, Najmul Huda, Man Mohan Sharma, Sandeep Bishnoi

Authors: Nishant Gandhi [1], Najmul Huda [1], Man Mohan Sharma [1], Sandeep Bishnoi [1]

[1] Department of Orthopaedics, TMMC & RC, Moradabad, UttarPradesh, India.

Address of Correspondence
Dr. Sandeep Bishnoi,
Assistant Professor, TMMC & RC, Moradabad, UttarPradesh, India.


Background: Various treatment modalities for unstable intertrochanteric fractures include osteosynthesis with dynamic hip screws or cephalomedullary nail and arthoplasty in selected cases. However, choice of implant for unstable intertrochanteric fracture is still debatable. Cephalomedullary nails are currently the means of fixation; Proximal Femoral Nail (PFN) and Proximal Femoral Nail Anti-rotation (PFNA) have their own advantages and disadvantages. The purpose of the present study was to compare the outcome of unstable intertrochanteric fracture by Proximal Femoral Nail versus Proximal Femoral Nail Anti-rotation in elderly patients. Recent literature search gives numerous publications on this topic, but there are very less literatures available in our country which includes combined functional and radiological parameters. The present study may contribute to the existing literature.
Methods: Sixty patients with unstable intertrochanteric fracture classified according to A.O. classification system (AO- 31.A2 & 31.A3) were included and randomized in two groups. Follow up was done for a period of nine months and complications were noted. Functional outcomes were assessed by using Harris Hip Score.
Results: Sixty patients were included in the study out of which, 30 patients were treated with Proximal Femoral Nail (Group A) and 30 with Proximal Femoral Nail Anti-rotation (Group B). The mean age of patients in group A and B was 71.47±4.16 and 70.17±8.96 years respectively. The demographic variables in each group were comparable. There was no significant difference in the mean Harris Hip Score (HHS) among both the groups. All the fractures united. Implant related complications like screw backout was equal in both the groups.
Conclusion: The study showed that there was no significant difference in the functional and radiological outcomes between the two groups. However considering the fact that the geriatric patients may have associated medical co morbidities, the use of proximal femoral nail anti-rotation may be a more viable option as it significantly reduces the duration of surgery and gives less radiation exposure as compared to proximal femoral nail.
Keywords: Intertrochanteric fracture, Elderly patients, Proximal femoral nail, Proximal femoral nail anti-rotation.


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How to Cite this Article:  Gandhi N, Huda N, Sharma MM, Bishnoi S | Management And Outcome Of Unstable Intertrochanteric Fracture By Proximal Femoral Nail Versus Proximal Femoral Nail Antirotation In Elderly Patients: A Prospective Comparative Study | Journal of Bone and Joint Diseases | September-December 2020; 35(3): 15-20.

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