J Korean Fract Soc.  2012 Oct;25(4):257-262. 10.12671/jkfs.2012.25.4.257.

The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation

• Kim JW
• Park HS
• Jang YS
• Choi JH
• Bae SJ
• Bae CI

• KMID: 1434063
• DOI: http://doi.org/10.12671/jkfs.2012.25.4.257

Abstract

PURPOSE
This study was performed to evaluate the results of treating intertrochanteric fracture with proximal femoral nail antirotation (PFNA).
MATERIALS AND METHODS
We performed PFNA on 41 intertrochanteric femur fracture patients from May 2008, to August 2010. We analyzed the operation time, blood loss, recovery of ambulatory function, T-score, the tip apex distance (TAD), the sliding distance of the blade, neck-shaft angle, and complications.
RESULTS
The mean operation time was 51 minutes and the mean amount of blood loss was 350 ml. The time to ambulation averaged 7.2 days. Thirty-two cases (79%) recovered their previous walking status at 6 months after operation. The average T-score was 3.3 and TAD was 12.3 mm (8.6~27 mm). 35 cases (87%) achieved acceptable reduction. The average amount of PFNA blade sliding was 3.3 mm. The neck-shaft angle was changed 2.6 degrees varus displacement at the final follow-up. There was one case of nonunion due to tuberculosis infection.
CONCLUSION
The findings from this study indicate that PFNA is a useful and reliable choice for the treatment of intertrochanteric fracture of the femur.

Keyword

Femur; Intertrochanteric fractures; PFNA

MeSH Terms

Displacement (Psychology)
Femoral Fractures
Femur
Follow-Up Studies
Hip Fractures
Humans
Nails
Tuberculosis
Walking

Figure

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  Fig. 1 A 87-year-old male who experienced intertrochanteric fracture from a fall. (A) Preoperative radiograph showed intertrochanteric fracture. (B) The fracture was reduced and fixed with proximal femoral nail antirotation. (C) Radiologic findings 17 months postoperatively showed bony union of the fracture site.

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  Fig. 2 A 85-year-old female who experienced intertrochanteric fracture from a fall. (A) Preoperative radiograph showed intertrochanteric fracture. (B) The fracture was reduced and fixed with proximal femoral nail antirotation (PFNA). (C) Two weeks after PFNA removed, radiologic findings showed non-union. (D) Because of the infected non-union, an antibiotic-loaded cement insertion was performed three weeks after PFNA removal.

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  Fig. 3 A 67-year-old female who experienced intertrochanteric fracture from a fall. (A) The preoperative radiograph showed intertrochanteric fracture. (B) The fracture was reduced and fixed with proximal femoral nail antirotation. (C) Radiologic findings 13 months postoperatively showed an impending cut-out.

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