The AO/ASIF proximal femoral nail antirotation (PFNA): a new design for the treatment of unstable proximal femoral fractures.
BACKGROUND
PFNA design compacts the cancellous bone to provide increased stability and has been bio-mechanically proven to retard rotation and varus collapse.


METHODS
Between 2006 and 2007, 62 consecutive patients with unstable proximal femoral fractures were treated with the PFNA.


RESULTS
Twenty males and 42 females with a mean age of 78 years (44-94) were reviewed. In 48 patients, the fracture resulted from a low energy injury. The majority of the fractures belonged to AO/ASIF types 31A2.3 (22) and 31A3.2 (29). Twelve patients required open reduction. The PFNA blade position was central in 52 patients with a mean tip-apex distance (TAD) of 12 mm (range 4-34 mm). Post-operatively, five patients died within 3 months and two patients were lost to follow-up. Forty-nine fractures united between 3 and 4 months. Four patients had delayed union. The PFNA blade cut out rate was 3.6%.


CONCLUSIONS
Unstable proximal femoral fractures were treated successfully with the PFNA. The PFNA blade appears to provide additional anchoring in osteoporotic bone. No results have been published on this new design.
Mereddy
Praveen
P
Department of Trauma and Orthopaedics, Wirral University Teaching Hospital, Upton, Wirral, Merseyside CH49 5PE, United Kingdom. mpkr3@yahoo.com
Kamath
Sri
S
Ramakrishnan
Muthukrishnan
M
Malik
Hamad
H
Donnachie
Nigel
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000601:surgery; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D011859:Radiography; D012399:Rotation