PROSPECTIVE STUDY TO COMPARE THE FUNCTIONAL OUTCOME OF LONG PROXIMAL FEMORAL NAIL (PFN) WITH TWO SCREW AND SINGLE HELICAL SCREW (PFNA) IN ELDERLY PATIENTS WITH FRACTURE INTERTROCHANTERIC FEMUR
Journal Title: National Journal of Medical and Dental Research - Year 2018, Vol 6, Issue 2
Abstract
Background:Intramedullary devices in management of unstable intertrochanteric fracture femur allow stable anatomical fixation without shortening the abductor lever arm or changing the proximal femoral anatomy. Between intramedullary devices like proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA), the helical blade of latter is believed to provide stability, compression and rotational control of the fracture with higher cut out strength. The following study was undertaken in an attempt to compare these two types of Intra-medullary devices. Method: Between September 2016 and September 2017, 40 patients with unstable intertrochanteric fractures fulfilling inclusion and exclusion criteria, were randomized into 2 groups to undergo CRIF with either standard PFN (n=20) or PFNA (n=20). They were compared, per-operative variables and postoperative parameters including functional evaluation till 6 months postoperatively. Result: Background demographic variables, fracture type and pre-injury ambulatory status were comparablebetween the groups. Operative duration of surgery, amount of blood loss and number of fluoroscopic images were significantly lower in PFNA group as compared to PFN group. Post op complication like cut out/z-effect, was lower in PFNA group compared to PFN group. Post opfunctional recovery as evaluated by persistent pain was comparatively lower in PFNA group and Harris hip scores were comparatively higher in PFNA group but statically non significant. Conclusion: PFNA significantly reduces the operative time, amount of blood loss and fluoroscopic imaging as compared to PFN. However PFNA offers no significant benefits over PFN in terms of post-operative functional recovery or complications.
Authors and Affiliations
Kundan Kushwah, Ankit K Kayathwal
Keywords
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