The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation

Jong Won Kim; Hyun Soo Park; Young Soo Jang; Jae Hyuk Choi; Sung Ju Bae; Chan Il Bae

doi:10.12671/jkfs.2012.25.4.257

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Kim, Park, Jang, Choi, Bae, and Bae: The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2012; 25(4): 257-262.

Published online: 19 October 2012

DOI: https://doi.org/10.12671/jkfs.2012.25.4.257

The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation

Jong Won Kim, M.D.^*, Hyun Soo Park, M.D., Young Soo Jang, M.D., Jae Hyuk Choi, M.D., Sung Ju Bae, M.D., Chan Il Bae, M.D.

Department of Orthopedic Surgery, KEPCO Medical Foundation, Hanil General Hospital, Seoul, Korea.

^*Department of Orthopedic Surgery, Gangnam Himchan Hospital, Seoul, Korea.

Address reprint requests to: Hyun Soo Park, M.D. Department of Orthopedic Surgery, Hanil General Hospital, 308, Uicheon-ro, Dobong-gu, Seoul 132-703, Korea. Tel: 82-2-901-3078, Fax: 82-2-900-1745, deanzang2@hanmail.net

Received 5 May 2012 Revised 5 May 2012 Accepted 21 June 2012

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.

Keywords: Femur, Intertrochanteric fractures, PFNA

Figures and Tables

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.

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.

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.

Table 1

Blade Length

Table 2

Position of Blade

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