Clinico-radiological and Functional outcome of Unstable Intertrochanteric Fractures by Proximal Femoral Nail Antirotation-2 (PFN-A2)

Abstract

Background: Unstable intertrochanteric fractures were one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to low-energy trauma and in young adults due to high velocity trauma. The incidence of these fractures was rising because of increasing number of senior citizens with osteoporosis. The problems associated with unstable intertrochanteric fractures were due to substantial morbidity and mortality, malunion, implant failure and associated medical conditions. Therefore, this has led to the development of intramedullary devices in the management of unstable intertrochanteric fractures. Objective:To analyze clinico-radiological and functional outcome of unstable intertrochanteric fractures by proximal femoral nail antirotation A2 (PFN-A2). Materials and methods:A prospective study with 73 adult patients with unstable intertrochanteric fractures according to Boyd & Griffin classification were treated with proximal femoral nail antirotation-2 (PFN-A2) in SSIMS, Davangere from October 2017 and September 2019. All the cases were followed at regular intervals as per our study protocol. The functional outcome were assessed with Harris Hip Score.Results: In the present study, 73 unstable intertrochanteric fractures underwent surgical fixation with proximal femoral nail antirotation 2 (PFN-A2). The functional results assessed by Harris Hip score showed excellent in 41 cases (56.16%), good in 15 cases (20.54%), fair in 12 cases (16.43%) and poor in 5 cases (6.84%). Conclusion:We conclude that the proximal femoral nail antirotation 2 (PFN-A2) was an ideal implant for unstable intertrochanteric fractures, leading to high rate of bone union restoring the lateral femoral wall, reducing the chances of implant failure and decreasing the post-operative morbidity by improving the functional quality of life.