Study of Outcome of Proximal Femur Nails Antirotation- II in Intertrochanteric Femur Fractures: A Study in Vidarbha Region

Abstract

Background: In the Asian population, proximal femoral nail anti-rotation II (PFNA-II), an implant device is one of the treatment modalities designated to treat unstable osteoportotic intertrochanteric fractures. The aim of the present study was to evaluate the functional outcome of PFNA-II in intertrochanteric femur fractures (that includes both stable and unstable). OBJECTIVE: The objective is to analyze clinico-radiological and functional outcomes of unstable intertrochanteric fractures by PFNA-II. Methodology: This was a prospective study conducted in the Department of Orthopaedics at Indira Gandhi Government Medical College, Nagpur (Vidarbha region) from August 2018 to August 2020. Patients’ demographic data such as age, gender, occupation, mode of injury, mode of trauma, presence of any co-morbidities, and fracture classification of the normal hip were recorded, from all the included patients 24 months follow-up was noted. The Boyd and Griffin’s classification was used. In the present study, the implant-related complications, including blade cutout, varus collapse, and loss of reduction, were observed. The functional evaluation of the patients was done based on the Modified Harris Hip Score. Outcome of the Study: Approximately 25 patients with radiological diagnosis of unstable intertrochanteric femur fractures were considered, out of which 13 (52%) patients were male and 12 (48%) patients were female, with the mean age of 68.61 ± 7.79 years, over the range of 40–90 years. The majority of cases were found to be in Boyd and Griffin classification, i.e., around 15 (60%), while in the Type III classification, there were 10 (40%) cases, and in the Type IV classification none of the cases were noted. Conclusion: PFNA-II provides good outcomes, low morbidity, and high mortality in elderly Indian populations with unstable intertrochanteric fractures. To the best of our knowledge, this was the first study done in Vidarbha region that focuses on the utility and feasibility of PFNA-II implant and represents its functional outcome.

Keywords

• boyd and griffin’s classification
• hip fractures
• intertrochanteric fractures
• proximal femoral nail anti-rotation ii
• vidarbha region