Evaluating Postoperative Hidden Blood Loss in Proximal Femoral Nail Anti-Rotation Fixation: The Role of Greater Trochanter Fracture Comminution.

BACKGROUND Intertrochanteric fractures can be managed using insertion of a proximal femoral nail anti-rotation (PFNA) intramedullary nail inserted into the femur. The helical blade used with the PFNA technique has the advantage of less bone removal and good biomechanical properties, but significant hidden blood loss (HBL) can occur. This study compared postoperative HBL in 219 elderly patients with intertrochanteric fractures using PFNA fixation, stratified by greater trochanter comminution status (comminuted vs non-comminuted).