+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Mid-term outcomes after intramedullary fixation of peritrochanteric femoral fractures using the new proximal femoral nail antirotation (PFNA)



Mid-term outcomes after intramedullary fixation of peritrochanteric femoral fractures using the new proximal femoral nail antirotation (PFNA)



Injury 41(8): 810-817



Controversy persists concerning the preferred treatment of peritrochanteric femoral fractures. The purpose of the present study was to evaluate the mid-term outcomes of the newly developed implants - proximal femoral nail antirotation (PFNA) for the stabilisation of this type of fracture. Between April 2006 and March 2008, 169 patients with peritrochanteric femoral fractures were treated with PFNA. As many as 26 patients were excluded from the study. According to the Orthopaedic Trauma Association (OTA) classification system, the remaining 143 fractures were classified as 19 cases of AO/OTA 31A1 fractures, 83 cases of 31A2 fractures, 28 cases of 31A3 fractures and 13 cases of 31A combined with proximal 32 fracture or separate proximal 32 fracture. The mean age of these patients was 67 years (range, 20-93 years). The operative time, the overall fluoroscopy time, the duration of hospitalisation and the surgical complications were noted. Patients were followed up for a mean of 21 months (range, 12-36 months). Functional outcomes were assessed according to the Harris hip scoring system. Fifteen patients (10%) required open reduction. The mean duration of surgery (from the beginning of close reduction to wound closure) was 72 min with a range between 45 and 170 min. The mean fluoroscopy time was 164 s with a range between 92 and 396 s. The mean time of hospital stay was 15 days. Postoperative X-rays showed a good or acceptable reduction in 134 cases (94%), and an ideal implant position in 131 cases (92%). There were 12 (8%) postoperative complications. All patients except one healed their fractures without any implant-specific complication (bending, breaking of the implant, cut out of the PFNA blade, femoral head penetration of the blade or ipsilateral fractures of the femoral shaft at the tip of the implant). The average time to bone healing was 16 weeks (range, 12-25 weeks). At the time of the latest follow-up, 106 patients (74%) were restored to their preoperative mobility. The mean Harris hip score was 84 points (range, 46-100 points). A total of 106 patients (74%) had an excellent or good outcome. According to the patients and/or their caregivers, outcome was described as satisfactory in 120(84%) of the 143 patients, and 36(90%) of the 40 patients, who were more than 80 years old. The results suggest that PFNA is a very effective and safe method in the treatment of different patterns of peritrochanteric femoral fractures. The fixation is adequate to maintain reduction over time even in osteoporotic bones.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 054383593

Download citation: RISBibTeXText

PMID: 20472234

DOI: 10.1016/j.injury.2010.03.020


Related references

A Comparison of the Clinico-Radiological Outcomes with Proximal Femoral Nail (PFN) and Proximal Femoral Nail Antirotation (PFNA) in Fixation of Unstable Intertrochanteric Fractures. Journal of Clinical and Diagnostic Research 11(7): Rc05-Rc09, 2017

Comparison of proximal femoral nail antirotation (PFNA) with AO dynamic condylar screws (DCS) for the treatment for unstable peritrochanteric femoral fractures. European Journal of Orthopaedic Surgery and Traumatology 24(3): 347-352, 2014

The short-term functional and radiological outcome of patients treated with the Synthes proximal femoral nail antirotation (PFNA) for unstable proximal femoral fractures. European Journal of Orthopaedic Surgery & Traumatology 21(7): 493-501, 2011

Radiographic Outcomes of Osteosynthesis Using Proximal Femoral Nail Antirotation (PFNA) System in Intertrochanteric Femoral Fracture: Has PFNA II Solved All the Problems?. Hip and Pelvis 29(2): 104-112, 2017

The AO/ASIF proximal femoral nail antirotation (PFNA): a new design for the treatment of unstable proximal femoral fractures. Injury 40(4): 428-432, 2009

Proximal femoral nail antirotation PFNA for treatment of osteoporotic proximal femoral fractures. European Journal of Orthopaedic Surgery & Traumatology 22(4): 301-305, 2012

Radiographic and functional results of osteosynthesis using the proximal femoral nail antirotation (PFNA) in the treatment of unstable intertrochanteric femoral fractures. Acta Orthopaedica et Traumatologica Turcica 44(2): 127-134, 2010

The proximal femoral nail antirotation (PFNA) in the treatment of proximal femoral fractures. Collegium Antropologicum 34(3): 937-940, 2010

Fixation of intertrochanteric femur fractures using Proximal Femoral Nail Antirotation (PFNA) in the lateral decubitus position without a traction table. Acta Orthopaedica et Traumatologica Turcica 48(5): 513-520, 2014

Treatment of trochanteric fractures with the PFNA (proximal femoral nail antirotation) nail system - report of early results. Bulletin of the Nyu Hospital for Joint Diseases 66(4): 276-279, 2008

The Asia proximal femoral nail antirotation versus the standard proximal femoral antirotation nail for unstable intertrochanteric fractures in elderly Chinese patients. Orthopaedics and Traumatology Surgery and Research 101(2): 143-146, 2015

An unusual case of femoral head perforation following fixation with proximal femoral nail antirotation (PFNA-II) for an unstable intertrochanteric fracture: Case report and literature review. Trauma Case Reports 20: 100178, 2019

Application of warm liquid in proximal femoral nail antirotation(PFNA) internal fixation. Zhongguo Gu Shang 32(2): 101-104, 2019

The nail-shaft-axis of the of proximal femoral nail antirotation (PFNA) is an important prognostic factor in the operative treatment of intertrochanteric fractures. Archives of Orthopaedic and Trauma Surgery 138(3): 339-349, 2018

Comparison of the reconstruction trochanteric antigrade nail (TAN) with the proximal femoral nail antirotation (PFNA) in the management of reverse oblique intertrochanteric hip fractures. Injury 46(12): 2389-2393, 2015