Vol. 10, Issue 4 (2024)

An intertrochanteric femur fracture is a fracture between greater and lesser trochanters of the femur bone. Unstable IT fractures are those where there is poor contact between fracture fragments, comminution, and weight-bearing forces tend to displace the fracture further.
Inter-trochanteric fractures are either seen in young adults due to high-energy trauma like in road traffic accidents or in elder population because of low-energy trauma like fall from height.
Proximal Femoral Nail has a two-screw system. There is one compression screw in addition to one anti-rotation screw.
Proximal Femoral Nail Anti-rotation II (PFN-A2) utilizes a single helical blade. The helical blade is believed to provide stability, compression as well as rotational control of the fracture. In a manner it condenses the cancellous bone during insertion into the neck providing additional anchoring and hence has higher cutout strength compared to other devices.[1]
 Aim: The aim of this study is to do a comparison of the radiological and clinical outcomes between two available implants: PFN and PFN A-II for the treatment of unstable inter-trochanteric fracture.
Methods: This was a retrospective study of patients operated between January 2022 to June 2023. 60 patients were selected in the study with unstable Boyd and Griffin’s types 2, 3 and 4. The data was collected from in-patient and out-patient records.
Following variables were noted:
•    Total duration of operation
•    Amount of Blood loss
•    Time taken for union of fracture
•    Post-operative complications. 
Follow – up examinations were done after the surgery at intervals of one month, three months, six months, and one year. Harris Hip Score was used for analysis of functional outcome.
X-Rays were done at intervals of one month, three months, six months and one year.
The student t-test and chi-square test were used with Stata, version 26.0 SPSS INC, Chicago, IL, USA for statistical analysis.
Results: Out of 60 cases included in the study, 30 were treated with PFN and 30 with PFN A-II. The mean age was 66.1 years. There was significant difference in mean blood loss between two groups: PFN (148.3+- 50 ml) and PFNA2 (122.7+-50 ml). The average HHS at the one year follow up was 84.9 for PFN and 89.2 for PFN A2. 
Conclusion: Our study showed statistically significant reduction in blood loss during operation and duration of operation. The Harris Hip Score also showed better results in cases operated with PFN AII but the results were not statistically significant. Further research is needed on this topic owing to small sample size of our study.