J Korean Hip Soc.  2010 Mar;22(1):79-85. 10.5371/jkhs.2010.22.1.79.

PFNA and PFN in Intertrochanteric Fractures: Comparison Study of Sliding

• Choo SK
• Oh HK
• Choi JY

• KMID: 1461085
• DOI: http://doi.org/10.5371/jkhs.2010.22.1.79

Abstract

PURPOSE
This study compared sliding between (a) lag screws of PFN (Proximal Femoral Nail, AO synthes) and (b) the helical blade of PFNA (Proximal Femoral Nail Antirotation, AO synthes) for femoral intertrochanteric fractures.
MATERIALS AND METHODS
We include in our study thirty seven cases who were classified as AO/OTA type A1 femoral intertrochanteric fractures and who underwent hip operations between October 2006 and December 2008. There were 19 patients in the PFN group and 18 in the PFNA group. Degrees of sliding were also measured with postoperative radiology on last follow up compared with immediate postoperative radiology. Both groups were also compared with regard too walking ability using the method of Koval.
RESULTS
Average sliding was 5.0+/-2.3 mm for lag screws of the PFN group and 2.8+/-1.3 mm for the helical blade of the PFNA group. The difference was statistically significant (p=0.04). Ambulatory abilities were not statistically different (p=0.33).
CONCLUSION
Patients in the PFNA group have less sliding of the implant, but their walking abilities are similar to patients in the PFN group.

Keyword

Femur; Intertrochanteric fracture; PFNA

MeSH Terms

Femur
Follow-Up Studies
Hip
Hip Fractures
Humans
Nails
Walking

Figure

• 

  Fig. 1 86 years old male patient with AO/OTA type A1.1 intertrochanteric fracture. (A) Preoperative radiology showed intertrochanteric fracture with intact posteromedial cortex. (B) Immediate postoperative radiology showed stable fixation with PFN. (C) Radiologic finding on his postoperative 5 months showed bony union of fracture site.

• 

  Fig. 2 82 years old female patient with AO/OTA type A1.2 intertrochanteric fracture. (A) Preoperative radiology showed intertrochanteric fracture with impaction of proximal fragment. (B) Immediate postoperative radiology showed stable fixation with PFNA. (C) Radiologic finding on his postoperative 8 months showed bony union of fracture site.

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  Fig. 3 Measurement of sliding using radiographs. (A) Immediate postoperative radiograph. A: Screw length at immediate postop, B: Screw sliding at immediate postop. (B) Follow up radiograph. A': Screw length at the last follow up, B': Screw sliding at the last follow up, Correction factor: A'/A, Corrected follow up sliding: B'/Correction factor, Result: Corrected follow up sliding - B

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