Comparison of proximal femoral nail antirotation (PFNA) with AO dynamic condylar screws (DCS) for the treatment for unstable peritrochanteric femoral fractures

Abstract

PurposeThe aim of this study was to compare the results of intramedullary fixation with those of plate-screw fixation for peritrochanteric femoral fracture patients older than 60 years old.MethodsThis article reports on a retrospective review of patients who had peritrochanteric femoral fractures and were treated with a 95° fixed-angle screw plate (DCS) or an intramedullary nailing system (PFNA). Patients with 79 fractures were enrolled in the study; 47 of them were treated with the PFNA system and 37 with the DCS. Followed for at least 1 year, the treatment groups were compared by taking into consideration all demographic and trauma variables.ResultsNo significant differences were discovered between the two groups with regard to side of injury, mechanism of trauma, associated comorbidities, AO fracture classification, average follow-up duration, mortality, and fracture reduction quality at the 1-year follow-up. The average surgical time was significantly lower in the PFNA group (57 min.) compared to the DCS group (87 min.). Longer operative time was needed in the DCS group, and thus, greater blood loss occurred compared to the PFNA group. The functional results of the PFNA group were found to be significantly better than those of the DCS group.ConclusionsOwing to some advantages, such as minimal exposure, reduced operative blood loss, and the achievement of biological fixation, PFNA is a better choice for the treatment for unstable peritrochanteric fractures.

Outcome of subtrochanteric fracture of the femur managed with proximal femoral nail

“…14 They found that the mean salvati-wilson hip score was 31 in the PFNA group and 26 in the DCS group. They had good results in 73.9% of the patients in the PFNA group and 70% in the DCS group.…”

Outcomes of Proximal Femoral Nail in Subtrochanteric Femur Fractures”- A Case Series

“…They had no complications like cut out or breakage of the implant. They concluded that long proximal femoral nail or long gamma nail is a reliable implant in treatment of subtrochanteric fractures Sahin EK et al did a comparison of proximal femoral nail antirotation with dynamic condylar screw in the elderly in the treatment of pertrochanteric fracture of the femur [17]. They found that the mean salvati-wilson hip score was 31 in the PFNA group and 26 in the DCS group.…”

Influence of different great trochanteric entry points on the outcome of intertrochanteric fractures: a retrospective cohort study

“…Despite the fact that an IM nail provides high union rates with low major complication rates, it has been associated with lateral trochanteric wall impingement that causes lateral trochanteric wall fracture during insertion, particularly for Asian patients with a narrow and short proximal femoral anatomy [17, 19, 21, 26–28]. PFNA II has been improved for the Asian patient with a flattened lateral surface, and the decreased mediolateral nail angle tends to reduce the risk of impingement with the lateral trochanteric wall [6, 19, 29].…”