Comparison of the Compression Hip Screw (CHS) and the Proximal Femoral Nail Antirotation (PFNA) for Intertrochanteric Femoral Fracture

Jong Min Lim; Jeung Il Kim; Jong Seok Oh; Kuen Tak Suh; Jae Min Ahn; Dong Joon Kang

doi:10.12671/jkfs.2010.23.4.360

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Lim, Kim, Oh, Suh, Ahn, and Kang: Comparison of the Compression Hip Screw (CHS) and the Proximal Femoral Nail Antirotation (PFNA) for Intertrochanteric Femoral Fracture

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2010; 23(4): 360-366.

Published online: 31 October 2010

DOI: https://doi.org/10.12671/jkfs.2010.23.4.360

Comparison of the Compression Hip Screw (CHS) and the Proximal Femoral Nail Antirotation (PFNA) for Intertrochanteric Femoral Fracture

Jong Min Lim, M.D., Jeung Il Kim, M.D., Jong Seok Oh, M.D., Kuen Tak Suh, M.D., Jae Min Ahn, M.D., Dong Joon Kang, M.D.

Department of Orthopedic Surgery, College of Medicine, Pusan National University, Busan, Korea.

Address reprint requests to: Jeung Il Kim, M.D. Department of Orthopedic Surgery, Pusan National University College of Medicine, 1-10, Ami-dong, Seo-gu, Busan 602-739, Korea. Tel: 82-51-240-7248, Fax: 82-51-247-8395, osteokim@yahoo.co.kr

Received 28 June 2010 Accepted 16 September 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the radiologic, clinical results between who had intertrochanteric fracture, treated with Compression Hip Screw (CHS) and Proximal Femoral Nail Antirotation (PFNA).

Materials and Methods

We retrospectively reviewed each 36 and 48 patients of intertrochanteric fracture which were treated with CHS or PFNA by one surgeon from January 2005 to June 2009. We evaluated mean operation time, amount of bleeding, radiologic results, and the clinical outcomes with the mobility score of Parker and Palmer, social function scoring system.

Results

The mean operation time, amount of bleeding were less in the PFNA group, there were 116.7 min, 486.1 ml for the CHS group versus 87.7 min, 289.6 ml for the PFNA group. The radiologic results were not significantly different. Decrease of mobility score of Parker and Palmer, social function score were similar. Proximal migration of leg screw and perforation of femoral head was 2 case and deep infection was 1 cases in CHS group.

Conclusion

There were no significant differences that are clinical and radiological results in treatment of intertrochanteric fracture using the CHS and PFNA. But PFNA is less invasive device than CHS, therefore it may be useful device in elderly patients.

Keywords: Femur, Intertrochanteric fracture, Compression hip screw, Proximal femoral nail antirotation

Figures and Tables

Fig. 1

For the Cleveland Index. The femoral head (axial view) was divided into nine zones to document the position of the tip of the implant.

Fig. 2

(A) Radiograph of a 70 years old male patient show an unstable intertrochanteric fracture as AO/ASIF classification A3.3.

(B) He was treated with internal fixation with CHS, wiring, and the radiograph taken 14 months later shows healing of the fracture.

Fig. 3

(A) Radiograph of a 74 years old female patient show an unstable intertrochanteric fracture as AO/ASIF classification A3.3.

(B) He was treated with internal fixation with PFNA and the radiograph taken 7 months later shows healing of the fracture.

Table 1

Comparative results of two groups

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