[Treatment results of pertrochanteric and subtrochanteric femoral fractures: a retrospective comparison of PFN and PFNA].
BACKGROUND
Can the helical blade in proximal femur nailing antirotation (PFNA) reach a better bony fixation than proximal femur nailing (PFN), thereby decreasing complication rates and improving clinical outcomes especially in osteoporotic bone?


METHODS
In a retrospective study complications and clinical treatment results of pertrochanteric and subtrochanteric femoral fractures were analyzed. For this purpose a group of patients stabilized with PFN (n=65) were compared to a patient group treated with PFNA (n=66). Objective and subjective parameters were acquired and analyzed by clinical follow-up studies using the Merle d'Aubigné score and X-ray evaluation. Individual bone quality was analyzed radiologically by determining the Singh index. The mean follow-up time was 7 months in each group.


RESULTS
The PFNA showed a decrease in postoperative implant-associated complications especially in osteoporotic bone and unstable fracture types.


CONCLUSIONS
The philosophy of the PFNA blade with better fixation through an increased implant-bone-interface and smaller cross-section, compaction of cancellous bone as well as an antirotational fixation, seems to show advantages compared to the double screw system of the PFN.
Penzkofer
J
J
Abt. für Unfallchirurgie, Sporttraumatologie und arthroskopische Chirurgie, Zentrum für Erkrankungen der Haltungs- und Bewegungsorgane (ZHBO), Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle, Saale, Deutschland. josef.penzkofer@gmx.de
Mendel
T
T
Bauer
C
C
Brehme
K
K
D000368:Aged; D005260:Female; D005264:Femoral Fractures / Q000150:complications* / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D011475:Prosthesis Failure; D012189:Retrospective Studies; D016896:Treatment Outcome