Key result
PFNA is linked to less blood loss, shorter surgeries, and shorter hospital stays versus hemiarthroplasty.
Why the study?
Treatment of unstable senile intertrochanteric fractures in the elderly requires balancing early mobilization with minimizing complications, and it is unclear which surgical option best addresses these issues.
Does PFN antirotation improve outcomes compared to bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures?
Cohort (n=40)
Does PFN antirotation improve outcomes compared to bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures?
PFNA provides less morbidity with early mobilization and good functional outcomes compared to hemiarthroplasty in elderly patients with intertrochanteric fractures.
May support individualized choice between PFNA and hemiarthroplasty in elderly unstable IT fractures; leaves open optimal selection pending prospective RCTs.
Introduction: Treatment of intertrochanteric fracture in elderly is not only to mobilise early but also to avoid complications and morbidity. With available treatments it is difficult to address all the issue with same surgical option. A recent advance for treatment of senile unstable intertrochanteric fracture is PFN antirotation which may help in early mobilisation with less complications. The purpose of this study is to compare the outcome of PFNA and hemiarthoplasty and to study advantages, disadvantages, complications of both the groups. Materials and Methods: 20 patients each were included in PFNA group and hemiarthroplasty group from January 2016 to January 2017 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. Hemiarthoplasty groups have better harris hip score in initial 3 months but similar score at the end of 1 year. Conclusion: PFNA provide less morbidity to patients with early mobilisations and good functional outcome. It can definitely be a better option than replacement in elderly intertrochanteric fracture.
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Munot et al. (2019) conducted a cohort in unstable senile intertrochanteric fractures (n=40). PFN antirotation (PFNA) vs. Bipolar hemiarthroplasty was evaluated on Blood loss, surgery time, hospital stay, complications, and Harris hip score. PFN antirotation resulted in significantly less blood loss, surgery time, and hospital stay compared to hemiarthroplasty, with similar complications and 1-year Harris hip scores.
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