Early Clinical Outcomes of Short versus Long Proximal Femoral Nail Anti-rotation (PFNA) in the Treatment of Intertrochanteric Fractures
https://doi.org/10.5704/MOJ.2107.017
- Author:
Loh JLM
1
;
Huang DME
1
;
Lei J
1
;
Yeo W
2
;
Wong MK
1
Author Information
1. Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
2. Orthopaedic Diagnostic Centre, Singapore General Hospital, Singapore
- Publication Type:Journal Article
- Keywords:
proximal femoral nail anti-rotation, intertrochanteric fractures, long PFNA, short PFNA, Asian population
- From:Malaysian Orthopaedic Journal
2021;15(No.2):115-121
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Both short and long PFNA are employed to
treat intertrochanteric fractures. Controversy exists in the
choice between the two nails as each implant has specific
characteristics and theoretical advantages. This retrospective
study seeks to examine the operative complication rates and
clinical outcomes of short versus long (Proximal Femoral
Nail Antirotation) PFNA in the treatment of intertrochanteric
fractures.
Materials and methods: Between July 2011 and February
2015, 155 patients underwent PFNA insertion. The decision
on whether to use a short or long PFNA nail, locked or
unlocked, was determined by the attending operating
surgeon. Visual Analogue Pain Score (VAS) Harris Hip
Scores (HHS), Short-form 36 Health Questionnaire (SF-36)
and Parker Mobility Scores (PMS) were collected at six
weeks, six months and one year post-operatively.
Results: A total of 137 (88.4%) patients were successfully
followed-up. Forty-two (30.7%) patients received a short
PFNA. The patients were similar in baseline characteristics
of age, gender, and comorbidities. Operative time was
significantly longer in the short PFNA group (62 ±17 mins)
versus the long PFNA group (56±17). While the patients in
both groups achieved improvement in all outcome measures,
there was no significant difference between the groups in
terms of HHS (61.0 ±16.0 vs 63.0 ±16.8, p=0.443), PMS
(2.3±1.5 vs 2.7±2.1, p=0.545) and VAS (1.7±2.9 vs 1.8 ±2.2
p=0.454). There were 3 (7.1%) and 7 (7.4%) complications
in the short versus long PFNA group, respectively.
Conclusion: Both short and long PFNA had similar clinical
outcomes and complication rates in the treatment of
intertrochanteric fractures in an Asian population.
- Full text:16.2021my1183.pdf
