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January 1, 2024Journal of Orthopaedics and Sports MedicineOpen Access

PFNA2 significantly improved 6-month Harris Hip Scores (88.57 vs 76.23, p=0.014) and accelerated mean bone union time (14.69 vs 18.47 weeks) compared to standard PFN in intertrochanteric fractures.

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Why the study?

Complications such as screw cut-out and rotational instability persist with standard PFN in unstable intertrochanteric fractures, prompting the development of PFNA2 with a helical blade to enhance fixation and stability in osteoporotic bone.

Does PFNA2 improve clinical and radiological outcomes compared to standard PFN in patients with unstable intertrochanteric fractures?

Population

50 patients with unstable intertrochanteric fractures (AO 31.A2 and 31.A3)

Comparison

PFN vs PFNA2

Design

Prospective comparative study

Follow-up

Six months

Key result

PFNA2 significantly improved 6-month Harris Hip Scores (88.57 vs 76.23, p=0.014) and accelerated mean bone union time (14.69 vs 18.47 weeks) compared to standard PFN in intertrochanteric fractures.

Authors

JKJayant KumarTata Main HospitalGVGaurav VatsaMittal hospitalSSSaurabh SumanAll India Institute of Medical Sciences, Deoghar

Discussion

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Member takes

Overview

Supports PFNA2 in osteoporotic intertrochanteric fractures; leaves open need for RCTs versus PFN.

Study Design

Type

RCT (n=50)

Blinding

Open-label

Randomization

Randomized

Multicenter

No

Structured PICO

Does PFNA2 improve clinical and radiological outcomes compared to standard PFN in patients with unstable intertrochanteric fractures?

P
Population
50 adult patients with closed unstable intertrochanteric fractures (AO 31.A2 and 31.A3) and no known comorbidities, randomized to PFNA2 or PFN and followed for 6 months.
I
Intervention
Proximal Femoral Nail Antirotation for Asia (PFNA2) surgical fixation
C
Comparator
Standard Proximal Femoral Nail (PFN) surgical fixation
O
Outcome
Clinical outcomes assessed using the Harris Hip Score and radiological outcomes by bone union time

Main Result

Absolute Event Rate: 88.57% vs 76.23%

p-value: p=0.014

PFNA2 demonstrated significantly faster bone union and better functional outcomes compared to standard PFN for unstable intertrochanteric fractures.

Limitations

  • Small sample size
  • Short follow-up duration of 6 months
  • Single-center study

Cite This Study

Kumar et al. (2024) conducted an RCT in Unstable intertrochanteric fractures (n=50). Proximal Femoral Nail Antirotation for Asia (PFNA2) vs. Standard Proximal Femoral Nail (PFN) was evaluated on Harris Hip Score at 6 months (p=0.014). PFNA2 significantly improved 6-month Harris Hip Scores (88.57 vs 76.23, p=0.014) and accelerated mean bone union time (14.69 vs 18.47 weeks) compared to standard PFN in intertrochanteric fractures.

synapsesocial.com/papers/6a71cd8aa7fbea1e440882f0https://doi.org/10.26502/josm.511500166
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