A Prospective Study To Evaluate Functional Outcome In Trochanteric Fractures Using Proximal Femoral Nail Antirotation ( PFN-AII) In Elderly
Journal Title: National Journal of Medical and Dental Research - Year 2017, Vol 6, Issue 1
Abstract
Background: The best surgical strategy for extra-capsular proximal femoral fractures (PFFs) is controversial in the elderly. Poor bone quality and neck screw instability can adversely affect the results with currently available fixation devices, which predominantly consist in dynamic hip screw-plates and proximal reconstruction nails. Hypothesis: The helical blade of the proximal femoral nail antirotation (PFN-AII) achieves better cancellous bone compaction in the femoral neck, thereby decreasing the risk of secondary displacement. Materials and Methods: A prospective study was conducted to assess the results of 20 elderly patients with trochanteric fractures [8 – stable (AO; 31-A1) and 12 – unstable (AO; 31-A2 and A3)] treated with PFNAII from December 2015 to April 2017 . Follow up functional and clinical assessments were done Results: The average age of the patients was 75.75 ± 6.42 (71–82) years. The fractures were closely reduced and fixed with PFNA-II. All of the fractures healed in an average of 14 weeks. The mean operation time was 46.68 ± 7.44 (30–77) minutes, and the mean blood loss was 115.77 ± 45.04 (50–300) ml. One patient was reoperated because of a poor blade position. At the time of the final follow-up, 80.7% of the patients returned to their pre-injury activity levels. PFNAII might be one treatment choice to solve the mechanical problems associated with these fractures because of its improved fixation strength, simpler technique, shorter operation time and reduced blood loss. Conclusion: Good results with relatively low complication rates can be achieved by PFNAII in trochanteric fractures in the elderly. Attention to implant positioning, fracture reduction and a good learning curve is mandatory for successful outcomes.
Authors and Affiliations
Abhilekh Mishra, Manish Bairagi, Santosh Mahawar
Keywords
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