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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...

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Three-Dimensional Reconstruction of Orbital Fractures
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Should We Reconstruct Coronal Plane Fractures in Multifragmentary Pertrochanteric Fractures? A Randomized Controlled

Velmurugesan Purnaganapathi Sundaram1, Nagashree Vasudeva1, Agraharam Devendra1

  • 1Department of Orthopaedics and Trauma, Ganga Medical Centre and Hospitals Pvt. Ltd, Coimbatore, India.

JB & JS Open Access
|July 2, 2026
PubMed
Summary

Wire augmentation in Proximal Femur Nail Antirotation Asia (PFNA-II) fixation significantly improved abductor strength recovery in patients with complex hip fractures. However, it did not show a significant difference in the modified Harris Hip Score (mHHS).

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Published on: November 8, 2024

Area of Science:

  • Orthopaedic surgery
  • Traumatology
  • Biomechanics

Background:

  • Coronal plane fractures in multifragmentary pertrochanteric (AO/OTA 31-A2) fractures are increasingly recognized.
  • The clinical significance and optimal management of these fractures require further investigation.

Purpose of the Study:

  • To evaluate the efficacy of wire augmentation during Proximal Femur Nail Antirotation Asia (PFNA-II) fixation for AO/OTA 31-A2 fractures.
  • To compare functional outcomes, specifically abductor strength and modified Harris Hip Score (mHHS), at 18 months post-surgery.

Main Methods:

  • A single-center randomized controlled trial involving 142 patients (Asian race, Indian ethnicity, >60 years) with AO-OTA 31-A2 fractures.
  • Patients were treated with PFNA-II, with or without wire augmentation for coronal fragments, assessed by preoperative CT.
  • 116 patients completed the 18-month follow-up for modified intention-to-treat analysis.

Main Results:

  • Wire augmentation resulted in significantly greater abductor strength recovery (Δ 8.21%, p < 0.001) at 18 months.
  • No significant difference was observed in the modified Harris Hip Score (mHHS) between the groups (Δ 3.31 points, p = 0.16).
  • Augmentation showed a clinically relevant 10% strength gain for fragments >50% and reduced varus collapse in controls.

Conclusions:

  • Wire augmentation enhances abductor strength recovery in PFNA-II fixation for AO/OTA 31-A2 fractures, particularly for larger fragments (>50%).
  • While abductor strength improves, the overall functional outcome (mHHS) remains similar between augmented and non-augmented groups.