Introduction: Unstable intertrochanteric fractures are difficult to manage and the choice of implant is critical for fracture fixation. The purpose of this study was to evaluate the functional and radiological outcome of proximal femoral nail antirotationII (PFNA II) in the treatment of unstable intertrochanteric fractures.Materials and Methods:We reviewed 45 patients of unstable intertrochanteric fractures, who were treated with the PFNA II between 2011 and 2013. Of which, 3 patients were died within 6 months of follow up. Hence, 42 patients were available for the study including 26 men and 16 women. The mean age was 61 years (range, 35 -90). Clinical evaluation was done using Harris hip score. The position of the blade in the femoral head was evaluated using Cleveland zones and tip apex distance. The fracture reduction was assessed using the Garden Alignment Index and postoperative fracture gap (mm) measurement.Results:The mean follow up period was 15.3 months (range, 9-27). Excellent to good results were accounted for 78% of cases according to Harris hip score. No cases of cut out or breakage of the implant noted. Implant removal was done in 2 patients due to persistent anterior thigh pain.Conclusion:We recommend PFNA II for fixation of unstable intertrochanteric fractures with less operative time and low complication rate. However, proper operative technique is important for achieving fracture stability and to avoid major complications.
Background and objectives: -Due to increasing life span and sedentary habits of elderly people fractures around hip are common. Among these, peritrochanteric fractures are commonest and they need immediate and stable reconstruction to mobilize the affected patients. METHODS: We studied 20 cases of peritrochanteric fractures treated by PF-LCP at KR hospital, MMCRI from Sep 2013-May 2014. They included 14 male and 6 female patients of age group from 28 yrs. to 75 yrs. the cause of injury was trivial in 80%, RTA in 20% of cases. Follow up was done for 6-8 months and assessed using Boyd and Griffin's classification and Harris hip score. RESULTS: Among the selected cases we evaluated both clinically and radiologically at the intervals of 6 th , 12 th , and 6 months we found that the final outcome was better than the cases treated with other type of implants and treated conservatively. The union rate was 40% (8/20) and 85% (17/20) at the 12 th week and 6 months follow up respectively. We had 1 case of complication as cut-out of screws from proximal fragment. CONCLUSION: The peritrochanteric fractures when treated with PF-LCP resulted in stable reconstruction of fracture and maintenance of anatomical reduction and bio-mechanical axis. Because of its strong angular fixation by the top three screws PF-LCP is advantageous in all types of bone density.
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