Comparative study of PFN A2 vs bipolar hemiarthroplasty in unstable senile intertrochanteric fractures

Introduction: Successful outcome in the treatment of intertrochanteric fracture in elderly lies in early mobilization of the patient so as to avoid the morbidity, complications and poor recovery. With the associated medical comorbidities and osteoporosis, presents a great challenge in selecting the surgical procedures in these patients. Even though the primary choice of surgery revolves around Osteosynthesis in these type of fractures, there is a conspiracy in the choice of implants for the fractures. Many surgeons have resorted to primary hemiarthroplasty in these fractures to avoid uncertainties and implant failures and able to allow full weight bearing walking after surgery. Off late PFNA2 nail have been preferably used to stabilize these fractures with relatively lesser complications and early mobilization of these patients. The purpose of this study is to compare the outcome of PFNA2 and hemiarthroplasty and to study advantages, disadvantages, complications of both the groups. Materials and Methods: 20 patients each were included in PFNA2 group and hemiarthroplasty group from May 2017 to August 2018 who satisfied the inclusion and exclusion criteria. Patient followed up upto 1 year. Patients were evaluated with multiple variables, complications and Harris hip score. Results: PFNA groups had significantly less blood loss, less surgery time, less hospital stay as compared to hemiarthroplasty group. Both groups had similar medical and Orthopaedic complications. PFNA patients can be mobilised early as with hemiarthroplasty group. Hemiarthroplasty groups have better Harris hip score in initial 3 months but similar score at the end of 1 year. Conclusion: PFNA2 provide less morbidity to patients with early mobilisation and good functional outcome. It can definitely be a better option than replacement in elderly intertrochanteric fracture.