Vol. 10, Issue 4 (2024)

Intertrochanteric fractures are a common injury in elderly individuals following falls and can be categorized as stable or unstable based on the displacement of bone fragments. Unstable fractures often require surgical intervention to restore mobility. Traditionally, dynamic hip screws (DHS) were used, but these have shown higher reoperation rates in unstable cases. Proximal femoral nails (PFNs) have gained popularity as a better alternative due to their biomechanical advantages, resulting in fewer implant failures and improved patient outcomes. This study evaluates the effectiveness of the Proximal Femoral Nail Antirotation II (PFN-A2), a newer intramedullary nail with a single helical blade, in treating unstable intertrochanteric fractures in a population from Tumkur, India.
Materials & Methods: The study included 39 participants treated at Sri Siddhartha Medical College Hospital, Tumkur, between June 2022 and June 2024. All had unstable intertrochanteric femur fractures and underwent closed reduction and internal fixation using PFN-A2 under spinal anesthesia. Follow-ups were conducted at 6, 12, and 24 weeks, assessing recovery using X-rays and the Modified Harris Hip Score (mHHS).
Results: There were no significant differences in recovery based on age or gender. The average surgery time was 48 minutes, and mean intraoperative blood loss was 97.8 ml. Significant improvements in mHHS scores were noted over time, from 58.9 at 6 weeks to 82.1 by 24 weeks, indicating consistent functional recovery for all patients.
Complications: Two cases of delayed wound healing were reported, both resolved with additional care.
Conclusion: PFN-A2 demonstrates significant and consistent improvements in hip function after surgery. The study's small sample size and single-center focus limit generalizability, and longer follow-up is needed to explore complications like implant failure.