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. 2019 Oct;10(Suppl 1):S71-S76.
doi: 10.1016/j.jcot.2019.02.004. Epub 2019 Feb 7.

Is PFNA-II a better implant for stable intertrochanteric fractures in elderly population ? A prospective randomized study

Navin Kumar Singh  1 , Vijay Sharma  1 , Vivek Trikha  1 , Shiva Gamanagatti  2 , Amit Roy  1 , Avtar Singh Balawat  1 , Palaniswamy Aravindh  1 , Amrut Raje Diwakar  1
Affiliations

Is PFNA-II a better implant for stable intertrochanteric fractures in elderly population ? A prospective randomized study

Navin Kumar Singh et al. J Clin Orthop Trauma. 2019 Oct.

Erratum in

  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1169-1171. doi: 10.1016/j.jcot.2020.09.032. Epub 2020 Sep 26. J Clin Orthop Trauma. 2020. PMID: 33013141 Free PMC article.
  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2021 Aug 5;21:101557. doi: 10.1016/j.jcot.2021.101557. eCollection 2021 Oct. J Clin Orthop Trauma. 2021. PMID: 34414071 Free PMC article.

Abstract

Introduction: Intertrochanteric fracture is one of the most common and severe fractures occurring in the elderly population. We conducted a randomized prospective study to compare the functional and radiological outcome of Proximal Femoral Nail anti-rotation-Asia(PFNA-II) and Dynamic Hip screw (DHS) used in fixation of stable (AO type 31 A1-A2.1) intertrochanteric fractures in elderly.

Methods: 60 elderly patients with stable intertrochanteric fractures treated with DHS and PFNA-II between August 2014 to Dec 2016 were enrolled in the study. Intraoperative variables-surgical time, blood loss, fluoroscopy time and post-operative variables-union rate, change in neck shaft angle(NSA), functional outcome in terms of Modified Harris Hip Score(HHS) & SF-12, complication rate and mortality at one year were studied and compared between both the groups.

Results: The mean age of patients in our study was 70.96 years. We found patients treated with DHS required significantly longer surgical time and had more blood loss compared to PFNA-II group. However, there was no significant difference in both the groups in terms of intra-operative fluoroscopy time, change in neck shaft angle, union rate, complication rate and Modified Harris Hip Score & SF-12 at three months; six months and one year follow-up.

Conclusions: Both DHS and PFNA-II can be used effectively in the treatment of elderly patients with stable intertrochanteric fracture with comparable outcome. However, in high-risk elderly patients requiring shorter surgical time and less blood loss, PFNA-II can be used.

Keywords: DHS; Elderly; Intertrochanteric fractures; PFNA-II.

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Figures

Fig. 1
Fig. 1
CONSORT 2010 flow diagram.
Fig. 2
Fig. 2
60 Years-old female patient with type 31 A1.2 intertrochanteric fracture fixed with DHS. (a) Pre-operative anteroposterior view. Fracture united at 6 months follow-up(b)Anteroposterior view and (c) Lateral view.
Fig. 3
Fig. 3
70 Year old female with type 31 A1.1 intertrochanteric fracture fixed with PFNA-II.Preoperative (a) Anteroposterior view and (b) Lateral view.Fracture united at 6 months follow-up(c) Anteroposterior view and (d) Lateral view.
See this image and copyright information in PMC

References

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