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. 2023 Sep 27;28(1):380.
doi: 10.1186/s40001-023-01332-y.

The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study

Yunfeng Tang #  1 , Dong Wang #  1 , Limin Wang  1 , Wei Xiong  1 , Qian Fang  1 , Wei Lin  2 , Guanglin Wang  3
Affiliations

The PFNA in treatment of intertrochanteric fractures with or without lateral wall fracture in elderly patients: a retrospective cohort study

Yunfeng Tang et al. Eur J Med Res. .

Abstract

Background: There is no consensus about intertrochanteric fractures with lateral wall treated with intramedullary nail-proximal femoral nail antirotation (PFNA). The aim of the present study was to compare function outcomes between lateral wall and no lateral wall fractures after surgery by PFNA.

Methods: This retrospective study evaluated patients with or without lateral wall fractures who underwent PFNA between January 2015 and June 2018. The operative time, intraoperative blood loss, time to fracture healing, complications and functional outcomes qualified by Harris hip score and Parker - Palmer mobility score (PPMS) were compared between the two groups.

Results: Two groups were comparable with regard to patient age, sexual distribution, mechanism of injury, fracture type, body mass index (BMI), Time to surgery, American Society of Anesthesiologists (ASA) score and quality of reduction. The incomplete group had a longer operation time (54.1 ± 8.74 min vs. 51.0 ± 9.86 min) and more intraoperative blood loss (228.4 ± 48.8 ml vs. 151.3 ± 43.5 ml) in comparison with the control group (P < 0.01). Regarding functional outcome, the HHSs of the two groups were 76.2 ± 11.6 vs 75.6 ± 12.5 at the 3 months (P = 0.603), 81.9 ± 9.4 vs 82.6 ± 8.7 at the six months (P = 0.224), 83.8 ± 6.6 vs 84.5 ± 6.0 at the twelve months 85.2 ± 5.5 vs 86.0 ± 5.8 at the twenty-four months (P > 0.05), respectively. Similar results were obtained about PPMS. We found no difference in Weight bearing time, Time of fracture healing, and Complications between incomplete group and intact group.

Conclusions: There is no substantial difference in functional results or complication rates for intertrochanteric fractures with lateral wall fractures, except from increased blood loss and operation time. We believe that an intramedullary nail will be sufficient to repair an intertrochanteric fracture with or without a lateral wall fracture.

Keywords: Intertrochanteric fractures; Lateral wall; Proximal femoral nail antirotation.

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Conflict of interest statement

No competing interests.

Figures

Fig. 1
Fig. 1
A 67-year-old female was treated for a right intertrochanteric fracture without lateral wall fracture (AO type A1.1) via closed reduction and internal fixation. a Radiograph of right hip showing intertrochanteric fracture without lateral wall fracture. b immediate postoperative radiograph showing sound reduction and after intramedullary nail. c three years follow-up radiograph showing bone union and no varus deformity
Fig. 2
Fig. 2
A 72-year-old female was treated for a right intertrochanteric fracture with lateral wall fracture (AO type A2.2) via closed reduction and internal fixation. a Radiograph of right hip showing intertrochanteric fracture with lateral wall fracture. b immediate postoperative radiograph after intramedullary nail. c Five years follow-up radiograph showing bone union and hip joint arthritis
See this image and copyright information in PMC

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