Fixing of intertrochanteric fractures with proximal femoral nail antirotation 2 by a double incision technique: a retrospective analysis

Background: The incidence of hip fractures is projected to rise from 1.66 million in 1990 to 6.26 million by 2050. Internal fixation is the most prevalent surgical intervention for intertrochanteric fractures. Hip fractures represent a significant healthcare issue amongst the elderly. The aim of this study is to evaluate a double incision technique in comparison to the conventional incision for fixing intertrochanteric fractures using the standard proximal femoral nail antirotation (PFNA2). Methods: This study took place at Dr. D. Y. Patil hospital in Navi Mumbai, India, from May 2023 to May 2024 employing an open-label, retrospective, randomized, and comparative methodology. A total of 100 patients with proven radiographic intertrochanteric fracture having undergone fixation with PFNA2 were analysed, with 50 undergoing the double incision and 50 serving as the stand control group. Results: The minimally invasive technique with a modified incision using the standard proximal femoral nail A2 can reduce bleeding, enhance precision for the entry point of the guidewire, shorten the time required for the entry, decrease soft tissue injuries, and provide better aesthetic outcomes. Conclusions: The current study delineates a minimally invasive surgical technique employing a double incision for the fixation of intertrochanteric fractures using the proximal femoral nail A2, underscoring its benefits.