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Fixation in Intertrochanteric Fractures Using Short Proximal Femoral Nail Anti-Rotation-2: A Functional and
Thangaraj Shenbagamoorthy Raagul1, K V Prem Kumar1, Karthik Seetharaman1
1Department of Orthopaedics, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Tamil Nadu, India.
Journal of Orthopaedic Case Reports
|May 12, 2025
Summary
The Short Proximal Femoral Nail Anti-Rotation-2 (PFNA-2) effectively treats intertrochanteric fractures in elderly patients, showing good functional recovery and minimal complications. This implant facilitates early mobilization, improving patient outcomes.
Area of Science:
- Orthopaedic surgery
- Geriatric trauma
- Biomedical engineering
Background:
- Intertrochanteric fractures are common in the elderly, often linked to osteoporosis and significant morbidity.
- Surgical intervention is crucial for early mobilization and complication reduction.
- The Short Proximal Femoral Nail Anti-Rotation-2 (PFNA-2) offers enhanced stability and biomechanical advantages for fracture fixation.
Purpose of the Study:
- To evaluate the functional and radiological outcomes of PFNA-2 in managing intertrochanteric fractures.
- To assess the efficacy of PFNA-2 in elderly patients with osteoporosis-related fractures.
- To determine complication rates and functional recovery associated with PFNA-2 fixation.
Main Methods:
- A prospective study of 50 patients with Boyd and Griffin Type 1-4 intertrochanteric fractures.
- Functional assessment using the Modified Harris Hip Score (MHHS).
- Radiological evaluation included fracture union, neck-shaft angle, and tip-apex distance (TAD), with follow-up for 6 months.
Main Results:
- Mean MHHS was 83.08, with 70% of patients achieving good to excellent outcomes.
- Younger patients showed significantly better functional results (P = 0.000).
- Low complication rates: 4% screw cut-out, 2% wound healing delay; mean TAD was 18.25 mm.
Conclusions:
- PFNA-2 provides effective fixation and favorable functional outcomes for intertrochanteric fractures in the elderly.
- The implant's reliability is supported by minimal complications and benefits of early mobilization.
- Further research with larger cohorts and longer follow-up is recommended to confirm these findings.
