Introduction: Intertrochanteric fractures are common osteoporotic fractures in adults above 70 years with high mortality and morbidity if not adequately treated. Common techniques for fixation of intertrochanteric fractures are sliding hip screw and plate or intramedullary nailing. PFNA2 is newer intramedullary load bearing device allowing early rehabilitation. We decided to compare the results of PFNA2 with PFN.
Methods: Prospective follow up study carried out at MIMER Medical College Talegaon (D) from June 2016 to December 2017. 53 patients with unstable intertrochanteric fractures were included after randomization and operated on fracture table in supine position with PFNA2 and PFN. We measured operative time, duration of hospital stay, modified Harris hip score, image intensifie time, complications at 6, 12, 24 and 36 weeks after surgery.
Results: Operative time, duration of hospital stay was almost same in PFNA2 and PFNA but image intensifier time was less in case of PFNA2 with significant P value. Varus malunion was less in PFNA2.
Conclusion: Both PFN and PFNA2 are equally effective for treatment of osteoporotic intertrochanteric fractures in elderly as they allow short incision, less blood loss and allow early rehabilitation with less mortality and morbidity. However PFNA2 gives less radiation exposure and more stability and should be the implant of choice in elderly osteoporotic patients if they can afford slightly higher cost of this new nail.