A Comparative Study between the Functional Outcome of Proximal Femoral Nailing and Proximal Femoral Nailing A2 in the Treatment of Intertrochanteric Fractures

Background: The intertrochanteric area is a complex system where muscles join, and forces are transferred.It establishes the biomechanics by determining how the hip's lever arm functions.Fractures in these zones can occur in a range of extremes, from low energy in older people with osteoporotic bones to high energy in young, healthy femurs.Numerous treatment approaches have been used in the past, and high-quality research is being done to enhance the quality of life and healing of patients following a fracture. Aims and objectives:(1) To determine the time of recovery of patients postsurgery.(2) To compare the functional outcome of patients with intertrochanteric fractures treated with proximal femoral nailing (PFN) and proximal femoral nailing antirotation 2 (PFNA2). Materials and methods:This study is a prospective comparative study.All patients who met our inclusion and exclusion criteria during the study period were selected.A total of 30 study participants were selected as per the simple random sampling technique in our study.Then the participants were divided into two groups (group A and group B) using single-blinding.Group A is intertrochanteric fracture treated with PFN, and group B is intertrochanteric fracture treated with PFNA2.Results: The most common Boyd and Griffin type of fracture was observed in our study.A majority of about 47% of participants had type II fracture, and the least, about 3%, had type IV fracture among our study participants.Among the study participants who had PFN, most of the patients in the age-group 51-60 had fair and poor outcomes.Among the PFNA2 group, most of the patients in the age-group 51-60 had excellent outcomes, which is better than PFN.The mean operative time for group A was calculated to be 73.25 minutes.The same was calculated to be 43.07 minutes for group B. The patients fixed with PFN in group A averaged at 2.35%, and the PFNA2 patients in group B had an average of 0.98% (Average reduction in Hb (%)).Conclusion: From our study, it is concluded that the functional outcome of fracture union remains the same irrespective of the implant used.However, it is significant to note that PFNA2 reduces the operative time and the intraoperative blood loss.Also, it prevents complications such as the 'Z' effect and superior cut-out, which are common in conventional PFN.