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Updated: Jan 4, 2026
Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Is PFNA-II a better implant for stable intertrochanteric fractures in elderly population ? A prospective randomized
Navin Kumar Singh1, Vijay Sharma1, Vivek Trikha1
1Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India.
Introduction:
Intertrochanteric fracture is one of the most common and severe fractures occurring in the elderly population. We conducted a randomized prospective study to compare the functional and radiological outcome of Proximal Femoral Nail anti-rotation-Asia(PFNA-II) and Dynamic Hip screw (DHS) used in fixation of stable (AO type 31 A1-A2.1) intertrochanteric fractures in elderly.
Methods:
60 elderly patients with stable intertrochanteric fractures treated with DHS and PFNA-II between August 2014 to Dec 2016 were enrolled in the study. Intraoperative variables-surgical time, blood loss, fluoroscopy time and post-operative variables-union rate, change in neck shaft angle(NSA), functional outcome in terms of Modified Harris Hip Score(HHS) & SF-12, complication rate and mortality at one year were studied and compared between both the groups.
Results:
The mean age of patients in our study was 70.96 years. We found patients treated with DHS required significantly longer surgical time and had more blood loss compared to PFNA-II group. However, there was no significant difference in both the groups in terms of intra-operative fluoroscopy time, change in neck shaft angle, union rate, complication rate and Modified Harris Hip Score & SF-12 at three months; six months and one year follow-up.
Conclusions:
Both DHS and PFNA-II can be used effectively in the treatment of elderly patients with stable intertrochanteric fracture with comparable outcome. However, in high-risk elderly patients requiring shorter surgical time and less blood loss, PFNA-II can be used.
