Treatment of unstable intertrochanteric femoral fractures in elderly population – A retrospective comparison between those treated by PFNA versus Primary Hemiarthroplasty of the hip

Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 19-23 | Ranade Uday Arun, Anne Sai Laxman

Author: Ranade Uday Arun [1], Anne Sai Laxman [1]

[1] Department of Orthopaedics, KIMS Hospitals, Kondapur, Hyderabad, Telangana – 500084, India

Address of Correspondence
Dr. Ranade Uday Arun,
Department of Orthopaedics, KIMS Hospitals, # 1-112/86, Survey No 55/ EE, Kondapur Village, Serilingampally Mandal, Hyderabad – 500084, India


Introduction: Unstable intertrochanteric femur fractures (IFF) have traditionally been reduced and internally fixed with either a hip screw and a side plate or more recently with the proximal femur nails. To counteract the complications of prolonged recumbency, some surgeons advocated using a primary hemiarthroplasty of the hip to treat such patients.
Aim:  Present study is being done to present the data at our institute in order to further our understanding of treatment of unstable IFFs in the elderly.

Methods and Material: A retrospective comparison study where data of 32 patients with unstable IFF (AO type 31 A2 and A3), who satisfied the inclusion and exclusion criteria and who underwent either a PFNA fixation or a primary hemiarthroplasty of the hip from the period of June 2018 to Jan 2019 was collected. Follow up was for a minimum of 12 months. Baseline data, perioperative data and post-operative data was collected. Statistical analysis was done by a statistician using SPSS software Ver 21.0.
Results: PFNA group showed significantly better Harris hip scores at the end of 12 months than the PHH group. Even the surgical time, intra-operative bleeding, amount of blood transfusions and length of stay was significantly less in PFNA group than PHH group.
Conclusions: Proximal femur fixation with PFNA device with its smaller incision, lower blood loss, faster operating time and shorter hospital stay has definitive advantages over a primary hemiarthroplasty hip.
Keywords: Unstable Intertrochanteric Femur Fractures, PFNA, Primary hemiarthroplasty Hip, Bipolar modular prosthesis, Proximal femur fixation


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How to Cite this article: Arun RU, Laxman AS. Treatment of unstable intertrochanteric femoral fractures in elderly population – A retrospective comparison between those treated by PFNA versus Primary Hemiarthroplasty of the hip. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):19-23.

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