Treatment of the Proximal Femoral Fractures with Proximal Femoral Nail Antirotation (PFNA)

Abstract

Purpose: To analyze the clinical and radiologic results of treatments in proximal femoral fracture with Proximal Femoral Nail-Antirotation (PFNA). Materials and Methods:We retrospectively reviewed the results of 21 cases of proximal femoral fracture treated with PFNA from September 2006 to October 2007 which could be followed up for minimum of more than a year. The mean age was 61.5 (20∼88) years old. Male were involved in 12 cases, female in 9 cases. The mean follow up was 14.3 (12∼18) months. The Garden alignment index, Cleveland index, tip apex distance were evaluated by post-operative radiologic evaluation and complications of bone union, failure of internal fixation and deformity were evaluated by follow up radiologic findings. Clinical results were assessed by social function score of Jensen and mobility score of Parker and Palmer at last follow up. Results: All fractures were united and the mean time to bone union was 15.7 (13∼18) weeks. Garden alignment index showed good results of above 'good' in 15 cases (71.4%), Cleveland index showed 14 cases (66.4%) positioning in zone 5 and tip apex distance showed 17.81 (±5.65∼27.52) mm in radiologic findings. The mean sliding of blade was 1.32 (0.34∼2.94) mm in follow up radiologic findings and fracture of distal locking screw area was found in 1 case as a complication. Among 21 cases, the function before injury was completely recovered in 15 cases (71.4%) which were assessed by social function score of Jensen and 13 cases (61.9%) by mobility score of Parker and Palmer. Conclusion: We think that PFNA is effective osteosynthetic device for proximal femur fracture with satisfactory radiologic and clinical outcomes.

Proximal Femoral Nail Antirotation versus Compression Hip Screw with Trochanter Stabilizing Plate for Unstable Intertrochanteric Hip Fractures

“…4,5,17) . 대전자부의 분 쇄골절이 동반된 경우나 전자부 후내측의 골절이 동반된 불안정성 골절에서 과도한 감입을 줄이고, 골편의 회전변 형이나 각형성을 예방하려는 목적으로 전자부 안정화 금속 판 (trochanter stabilizing plate, TSP)을 추가로 사용하여 좋은 결과를 보고하고 있다 4,14,21) .…”