Why the study?
Does the helical blade of PFNA reduce implant sliding compared to lag screws of PFN in patients with AO/OTA type A1 femoral intertrochanteric fractures?
Does the helical blade of PFNA reduce implant sliding compared to lag screws of PFN in patients with AO/OTA type A1 femoral intertrochanteric fractures?
The helical blade of PFNA results in significantly less implant sliding compared to lag screws of PFN in intertrochanteric fractures, though walking abilities remain similar.
Helical blade may reduce sliding in observational data; leaves open whether this affects outcomes or warrants randomized trials.
Purpose: This study compared sliding between (a) lag screws of PFN (Proximal Femoral Nail, AO synthes) and (b) the helical blade of PFNA (Proximal Femoral Nail Antirotation, AO synthes) for femoral intertrochanteric fractures. Materials and Methods: We include in our study thirty seven cases who were classified as AO/OTA type A1 femoral intertrochanteric fractures and who underwent hip operations between October 2006 and December 2008. There were 19 patients in the PFN group and 18 in the PFNA group. Degrees of sliding were also measured with postoperative radiology on last follow up compared with immediate postoperative radiology. Both groups were also compared with regard too walking ability using the method of Koval. Results: Average sliding was 5.0±2.3 mm for lag screws of the PFN group and 2.8±1.3 mm for the helical blade of the PFNA group. The difference was statistically significant (p=0.04). Ambulatory abilities were not statistically different (p=0.33). Conclusion: Patients in the PFNA group have less sliding of the implant, but their walking abilities are similar to patients in the PFN group.
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Choo et al. (2010) studied this question.
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