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RESULTS OF TFN AND SHORT PFNA-II IN UNSTABLE TROCHANTERIC FRACTURES: A RETROSPECTIVE COMPARATIVE STUDY

Background: Advancements in modern medicine have given people the opportunity to live longer. The resultant increase in the elderly population
has led to a higher incidence of peri-trochanteric fractures of the femur. The preferred implant for the comminuted unstable variety has been
intramedullary nails with one or two head/neck compression screws, which are known to have high rate of complications like screw cut-out, back
out, Z-effect, varus collapse and rotational instability, especially in the osteoporotic patients leading to the development of helical blade systems.
Here we have compared the results of trochanteric xation nail (TFN) and short proximal femoral nail antirotation (PFNA)-II.
Methods: It was a retrospective, comparative study in seventy-ve patients with comminuted unstable trochanteric fractures (AO classication31A2) treated using TFN in 34 and short PFNA-II in 41 patients with a minimum follow up period of six months.
Results: Most of the data were comparable between the two groups except: signicantly higher operation time and implant-related complications
in the TFN group. No signicant differences in the functional outcome between the two groups were noted as indicated by Harris Hip Score at six
months.
Conclusion: Short PFNA-II should be used in preference to TFN for comminuted unstable trochanteric fractures with no sub-trochanteric
extension in the elderly osteoporotic patients in view of the shorter operative time, easier insertion and lower complications rate.