title: [Results and complications of pertrochanteric hip fractures using an intramedullary nail with a helical blade (proximal femoral nail antirotation) in 200 patients].
abstract: OBJECTIVE
  Evaluation of the surgical management, outcome and complications in patients with pertrochanteric fractures treated with PFNA nail.
  
  
  METHODS
  A retrospective study was conducted on 200 patients treated consecutively between April 2010 and February 2012. Radiological assessments were performed before and after the surgery, and during the follow-up (fracture reduction, blade position, consolidation or collapse signs). A clinical evaluation was performed as regards walking capabilities. The results were compared with those of a previous study on 700 patients treated with gamma 3 and TFN nails.
  
  
  RESULTS
  The blade position was centre-centre in 64% of patients, and decreased to 53% in the mechanical complications group. Tip-apex distance was less than 25mm in 91.5%. The average hospital stay was 9.17 days, with a mean post-surgery stay of 5.95 days. Complications (7.5%): 2 cut out (1%), one cut through (0.5%), 4 cases of helical blade sliding (2%), one failure in distal locking procedure (0.5%), 2 cases with painful fasciae latae (1%), one union delay (0.5%), 2 cases of non-union with hardware failure (1%), one case of intense bleeding related to distal locking of the nail (0.5%), and one case of avascular necrosis (0.5%).
  
  
  CONCLUSIONS
  The PFNA helical blade system seems to reduce the incidence of cut out and cut through in osteoporotic bone. Blade position was one of the main parameters associated with mechanical complications.
authors.affiliation: Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario del Río Hortega, Valladolid, Spain. nacho.ams@gmail.com
authors.forename: I
authors.initials: I
authors.lastname: Aguado-Maestro
authors.forename: R
authors.initials: R
authors.lastname: Escudero-Marcos
authors.forename: J M
authors.initials: JM
authors.lastname: García-García
authors.forename: N
authors.initials: N
authors.lastname: Alonso-García
authors.forename: D
authors.initials: D
authors.lastname: Pérez-Bermejo D
authors.forename: H J
authors.initials: HJ
authors.lastname: Aguado-Hernández
authors.forename: J
authors.initials: J
authors.lastname: Nistal-Rodríguez
authors.forename: M
authors.initials: M
authors.lastname: García-Alonso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails / Q000009:adverse effects; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies