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Introduction: Intertrochanteric femur fractures are among the most common injuries in the elderly population and represent a major public health issue. Treatment aims to achieve stable fixation that allows early mobilization and minimizes complications. The choice of implant plays a critical role in clinical outcomes, particularly in unstable fracture patterns.
Objectives: The aim of this study was to compare the intraoperative parameters, functional outcomes, union times, and complications between proximal femoral nail anti-rotation-II (PFNA-II) and trochanteric femur nail (TFN) in patients with unstable intertrochanteric femur fractures.
Materials And Methods: A prospective, randomized, and comparative study was conducted in a tertiary care center over a period of 18 months. One hundred patients aged 50-85 years with Boyd and Griffin type III fractures were divided into two groups. Group A (n = 50) was treated using TFN, while Group B (n = 50) received PFNA-II. Surgical techniques, post-operative care, and rehabilitation protocols were standardized. Data on operative time, intraoperative blood loss, union duration, Harris Hip scores (HHS), and complications were collected and statistically analyzed.
Results: The PFNA-II group had shorter operative times (Mean 65.5 min. vs. 71.5 min) and less blood loss (253 ± 36.4 mL vs. 275 ± 35.1 mL) than the TFN group. Average union time was similar between groups. Mean HHS at 6 months was higher in the PFNA-II group (67.83 ± 8.05) than the TFN group (71.72 ± 7.45), though the difference was not statistically significant. PFNA-II also showed a lower incidence of implant-related complications.
Conclusion: PFNA-II offers certain intraoperative advantages and trends toward better functional outcomes and fewer complications, but the differences with TFN were not statistically significant. Both implants are viable for the treatment of unstable intertrochanteric fractures.
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http://dx.doi.org/10.13107/jocr.2025.v15.i08.5980 | DOI Listing |
Front Med (Lausanne)
August 2025
Department of Orthopaedics, Peking University Third Hospital, Beijing, China.
Introduction: Intertrochanteric femoral fractures (IFF) are among the most common lower limb fractures in the older population. Our team has developed a new cephalomedullary nail design called the proximal femoral universal nail (PFUN). This study aimed to compare the clinical outcomes of PFUN and proximal femoral nail anti-rotation (PFNA) internal fixation for the treatment of IFF in older patients.
View Article and Find Full Text PDFIndian J Orthop
August 2025
Kulkarni Orthopaedic Centre, Opposite Bharati Vidya Peeth, Jule Solapur, Solapur, 413001 Maharashtra India.
Background: Intertrochanteric (IT) fractures in the elderly are a major orthopaedic challenge due to osteoporotic bone quality, implant anchorage difficulties, and associated comorbidities. These factors contribute to nearly one-third mortality within a year of injury, representing a significant global health and economic burden.
Methods: Historically, stable IT fractures were treated with surface implants such as dynamic hip screws (DHS), whilst intramedullary (IM) implants like proximal femoral nails (PFN) were reserved for unstable patterns.
Indian J Orthop
August 2025
Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, India.
Background: The life expectancy of the elderly population is increasing; hence, a rise in both intracapsular and extracapsular hip fractures. Early surgical intervention and ambulation are crucial to improving outcomes and reducing complications associated with recumbency. The optimal management of intertrochanteric femur fractures (IFFs) in elderly patients especially in cases of osteoporotic bone or high-risk fractures remains debated.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
August 2025
Brown University, Providence, USA.
J Orthop Case Rep
August 2025
Department of Orthopaedic, Krishna Vishwa Vidhyapeeth, Karad, Maharashtra, India.
Introduction: Intertrochanteric femur fractures are among the most common injuries in the elderly population and represent a major public health issue. Treatment aims to achieve stable fixation that allows early mobilization and minimizes complications. The choice of implant plays a critical role in clinical outcomes, particularly in unstable fracture patterns.
View Article and Find Full Text PDF