[Comparison of proximal femoral nail antirotation-II and proximal femoral nail antirotation in fixation of femoral intertrochanteric fracture].

OBJECTIVE

To compare and evaluate the effect of PFNA-II and PFNA for the treatment of femoral intertrochanteric fracture.

METHODS

From August 2009 to August 2012, 238 patients with intertrochanteric fracture in Department of Orthopedics, Affiliated Jiangsu Shengze Hospital of Nanjing Medical University treated with PFNA-II (n=112) and PFNA (n=126) were selected in our study. The two treatment groups were comparable in features before the fracture occurred. The clinical data of surgical trauma, complications and postoperative function of the two groups were statistically compared in our study.

RESULTS

The mean operation time in PFNA-II group was significantly shorter than that in PFNA group (54.7±12.1) min vs (67.5±12.9) min, P=0.000 2). Blood loss and fluoroscopy time differed significantly, (77.8±16.4) ml and (2.5±1.1) min in PFNA-II group compared with (110.6±21.9) ml and (3.2±1.4) min in PFNA group. Eight unilateral femoral shaft splits at the distal end of the nail were observed intra-operatively, 7 in PFNA group and 1 in PFNA-II group (P=0.049). During the follow-up period, there was one re-fracture and one implant failure during the follow up period in PFNA group, and only one implant failure in PFNA-II group. Thirty-eight patients complained about hip pain and 46 thigh pain in PFNA groups. Nineteen patients complained about hip pain and 7 thigh pain in PFNA-II groups. There were no significant differences in the final functional outcome between the two devices.

CONCLUSION

Compared with PFNA, PFNA-II obviously shows some advantages, namely easy operation, less blood loss, less operative time and less fluoroscopy time. However, there were no significant differences of functional outcome between the two nails.