Abstract
Objectives
To compare the results between the proximal femoral nail anti-rotation (PFNA) and
the third generation gamma nail (TGN) in the treatment of trochanteric fractures.
Methods
Between April 2007 and May 2008, 107 consecutive patients older than 60 years with
trochanteric femoral fractures were treated with PFNA or TGN. The preoperative variables
including patient age, gender, fracture classification, walking ability and American
Society of Anaesthesiologists (ASA) rating of operative risk were summarised. Operative
time, fluoroscopy time, blood loss, and any intra-operative complication were recorded
for each patient. Follow-up was undertaken at 3, 6, and 12 postoperative months, and
yearly thereafter. Plain AP and lateral radiographs were obtained at all visits. All
changes in the position of the implant, complications, or fixation failure were recorded.
Hip range of motion, pain about the hip and the thigh, walking ability score and return
to work status were used to compare the outcomes.
Results
There were 55 patients in the PFNA group and 52 in the TGN group. The two groups were
comparable with regard to the preoperative variables. The mean follow-up time was
17.5 months (range 12–24). Patients treated with a PFNA experienced a shorter fluoroscopy
time and less blood loss. Sixteen patients were lost during the follow-up period.
All the other fractures were radiographically healed at the last visit. There were
no significant differences between the groups in terms of functional outcomes, hospital
stay, intra-operative and postoperative complications.
Conclusions
PFNA provides less blood loss and shorter fluoroscopy time but no advantages in functional
outcome, intra-operative and postoperative complications when compared with TGN. These
two implants were comparable in the treatment of trochanteric fractures.
Keywords
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Article info
Publication history
Accepted:
March 2,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
