Proximal femoral nail anti-rotation-2 in intertrochanteric fractures: Experience from the Kingdom of Saudi Arabia

Abstract

Proximal femoral nail anti-rotation (PFNA)-2 is an intramedullary implant designed specifically for the Asian population for managing intertrochanteric (IT) fractures among the elderly. We presented this cases series with an objective to use and document the effectiveness of PFNA-2 for the management of unstable IT fracture among patients aged 60 years and above in the Kingdom of Saudi Arabia. Four females were treated above 65 years with severe pain in the hip region after a trivial fall on the ground over a period of 2 years (2018–2020), diagnosed with T3 and T4 unstable IT fracture. All the patients were hypertensive, with two having diabetes. It was decided to manage the fracture site by PFNA-II implant following baseline clinical and biochemical investigations. The duration of surgery took around 70–75 min with a blood loss of 100–150 ml, and there was no intraoperative complication. Early mobilisation and toe touch walking was achieved within 2 days postoperatively. Harris hip score was 'good' for all patients within 3 months, which became 'excellent' after 6 months for all except one. Union was achieved in all the cases with a full weight-bearing period ranging from 9 to 11 weeks. The usage of PFNA-2 for IT fractures among elderly having co-morbidities such diabetes and hypertension is perfectly promising good results for such reason we strongly recommend it. However, future prospective clinical trials using sufficient sample size, comparing PFNA-2 with PFN and dynamic hip screws are needed for better decision-making.

Keywords

• elderly
• intertrochanteric fracture
• proximal femoral nail anti-rotation-2
• saudi arabia