title: Treatment of Unstable Intertrochanteric Fractureswith Proximal Femoral Nail Antirotation II: Our Experience in Indian Patients.
abstract: BACKGROUND
  Unstable intertrochanteric fractures are difficult to manage and the choice of implant is critical for fracture fixation. The purpose of this study was to evaluate the functional and radiological outcome of proximal femoral nail antirotationII (PFNA II) in the treatment of unstable intertrochanteric fractures.
  
  
  METHODS
  We reviewed 45 patients of unstable intertrochanteric fractures, who were treated with the PFNA II between 2011 and 2013. Of which, 3 patients were died within 6 months of follow up. Hence, 42 patients were available for the study including 26 men and 16 women. The mean age was 61 years (range, 35 -90). Clinical evaluation was done using Harris hip score. The position of the blade in the femoral head was evaluated using Cleveland zones and tip apex distance. The fracture reduction was assessed using the Garden Alignment Index and postoperative fracture gap (mm) measurement.
  
  
  RESULTS
  The mean follow up period was 15.3 months (range, 9-27). Excellent to good results were accounted for 78% of cases according to Harris hip score. No cases of cut out or breakage of the implant noted. Implant removal was done in 2 patients due to persistent anterior thigh pain.
  
  
  CONCLUSIONS
  We recommend PFNA II for fixation of unstable intertrochanteric fractures with less operative time and low complication rate. However, proper operative technique is important for achieving fracture stability and to avoid major complications.
authors.affiliation: Department of Orthopaedics, AIIMS, New Delhi-110029, India.
authors.forename: G N Kiran
authors.initials: GN
authors.lastname: Kumar
authors.affiliation: Department of Orthopaedics, AIIMS, New Delhi-110029, India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Sharma
authors.affiliation: Department of Orthopaedics, GGS Medical College, Faridkot-151203, India.
authors.forename: Kavin
authors.initials: K
authors.lastname: Khatri
authors.affiliation: Department of Orthopaedics, AIIMS, New Delhi-110029, India.
authors.forename: Kamran
authors.initials: K
authors.lastname: Farooque
authors.affiliation: Department of Orthopaedics, Institute For Medical Sciences And Research Centre, Jaipur National University, Jagatpura, Jaipur-302017, India.
authors.forename: Devendra
authors.initials: D
authors.lastname: Lakhotia
authors.affiliation: Department of Orthopaedics, AIIMS, New Delhi-110029, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Sharma
authors.affiliation: Department of Orthopaedics, AIIMS, New Delhi-110029, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Meena
keywords: Fixation; Harris hip score; intertrochanteric fracture; intra medullary; proximal femoral nail antirotation II; unstable