Jong Won Kim; Hyun Soo Park; Young Soo Jang; Jae Hyuk Choi; Sung Ju Bae; Chan Il Bae

doi:10.12671/jkfs.2012.25.4.257

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Original Article
The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation: Jong Won Kim, M.D., Hyun Soo Park, M.D., Young Soo Jang, M.D., Jae Hyuk Choi, M.D., Sung Ju Bae, M.D., Chan Il Bae, M.D.; Journal of the Korean Fracture Society 2012;25(4):257-262.
DOI: https://doi.org/10.12671/jkfs.2012.25.4.257
Published online: October 19, 2012

Department of Orthopedic Surgery, KEPCO Medical Foundation, Hanil General Hospital, Seoul, Korea.

^*Department of Orthopedic Surgery, Gangnam Himchan Hospital, Seoul, Korea.

Address reprint requests to: Hyun Soo Park, M.D. Department of Orthopedic Surgery, Hanil General Hospital, 308, Uicheon-ro, Dobong-gu, Seoul 132-703, Korea. Tel: 82-2-901-3078, Fax: 82-2-900-1745, deanzang2@hanmail.net

• Received: May 5, 2012 • Revised: May 5, 2012 • Accepted: June 21, 2012

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Abstract
REFERENCES

Abstract

Purpose
This study was performed to evaluate the results of treating intertrochanteric fracture with proximal femoral nail antirotation (PFNA).
Materials and Methods
We performed PFNA on 41 intertrochanteric femur fracture patients from May 2008, to August 2010. We analyzed the operation time, blood loss, recovery of ambulatory function, T-score, the tip apex distance (TAD), the sliding distance of the blade, neck-shaft angle, and complications.
Results
The mean operation time was 51 minutes and the mean amount of blood loss was 350 ml. The time to ambulation averaged 7.2 days. Thirty-two cases (79%) recovered their previous walking status at 6 months after operation. The average T-score was 3.3 and TAD was 12.3 mm (8.6~27 mm). 35 cases (87%) achieved acceptable reduction. The average amount of PFNA blade sliding was 3.3 mm. The neck-shaft angle was changed 2.6 degrees varus displacement at the final follow-up. There was one case of nonunion due to tuberculosis infection.
Conclusion
The findings from this study indicate that PFNA is a useful and reliable choice for the treatment of intertrochanteric fracture of the femur.
Key words: Femur, Intertrochanteric fractures, PFNA

REFERENCES

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Fig. 1

A 87-year-old male who experienced intertrochanteric fracture from a fall.

(A) Preoperative radiograph showed intertrochanteric fracture.

(B) The fracture was reduced and fixed with proximal femoral nail antirotation.

(C) Radiologic findings 17 months postoperatively showed bony union of the fracture site.

Fig. 2

A 85-year-old female who experienced intertrochanteric fracture from a fall.

(A) Preoperative radiograph showed intertrochanteric fracture.

(B) The fracture was reduced and fixed with proximal femoral nail antirotation (PFNA).

(C) Two weeks after PFNA removed, radiologic findings showed non-union.

(D) Because of the infected non-union, an antibiotic-loaded cement insertion was performed three weeks after PFNA removal.

Fig. 3

A 67-year-old female who experienced intertrochanteric fracture from a fall.

(A) The preoperative radiograph showed intertrochanteric fracture.

(B) The fracture was reduced and fixed with proximal femoral nail antirotation.

(C) Radiologic findings 13 months postoperatively showed an impending cut-out.

Table 1

Blade Length

Table 2

Position of Blade

Figure & Data

REFERENCES

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The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation

J Korean Fract Soc. 2012;25(4):257-262. Published online October 31, 2012

DOI: https://doi.org/10.12671/jkfs.2012.25.4.257

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The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation

Fig. 1 A 87-year-old male who experienced intertrochanteric fracture from a fall. (A) Preoperative radiograph showed intertrochanteric fracture. (B) The fracture was reduced and fixed with proximal femoral nail antirotation. (C) Radiologic findings 17 months postoperatively showed bony union of the fracture site.

Fig. 2 A 85-year-old female who experienced intertrochanteric fracture from a fall. (A) Preoperative radiograph showed intertrochanteric fracture. (B) The fracture was reduced and fixed with proximal femoral nail antirotation (PFNA). (C) Two weeks after PFNA removed, radiologic findings showed non-union. (D) Because of the infected non-union, an antibiotic-loaded cement insertion was performed three weeks after PFNA removal.

Fig. 3 A 67-year-old female who experienced intertrochanteric fracture from a fall. (A) The preoperative radiograph showed intertrochanteric fracture. (B) The fracture was reduced and fixed with proximal femoral nail antirotation. (C) Radiologic findings 13 months postoperatively showed an impending cut-out.

Fig. 1

Fig. 2

Fig. 3

The Treatment of Intertrochanteric Femoral Fracture with Proximal Femoral Nail Antirotation

Table 1

Blade Length

Table 2

Position of Blade

Table 1 Blade Length

Table 2 Position of Blade