Randomised comparative study in management of unstable intertrochanteric fracture with PFN V/S PFN A2 - functional and radiological out-come

Abstract

A prospective, randomized, comparative study, this study was conducted in Institute Of Orthopaedic Research and Accident Surgery (IORAS) Devadoss Multispeciality Hospital, Madurai, Tamil Nadu. Study period of Two years from April 2016 – May 2017. Since this fracture is more common in the elderly patients, the aim of treatment is prevention of mal union and early mobilization, taking all the factors into consideration surgery by internal fixation of the fracture is ideal choice. A wide modalities of internal fixation are available for the management of these fractures, most commonly used implant is dynamic hip screw(DHS) with side plate, this is a controlled collapsible fixation device, unstable intertrochantric fracture are difficult to treat, so intramedullary devices such as proximal femoral nail(PFN) are biomechanically stronger and more rigid compared to extramedullary devices such as DHS, PFN also has showed more number of post operative complications like implant failure, screw cutout in case of unstable intertrochantric fractures, to improvise in 2009 AO/ASIF introduced Proximal femoral nail antirotation (PFN A2) which claimed better rotation and angular stability with helical blade and better functional outcome in treating unstable intertrochantric fractures when compared to PFN. So to evaluate and compare functional and radiological outcome of the patients having unstable intertrochantric fractures treated by two different methods of fixation with PFN and PFNA2. This study is taken up to find out the efficacy of newer implant PFN A2 over PFN.