Comparative Study of Functional and Radiological Outcomes of Intertrochanteric Fracture Fixation by Proximal Femoral Nail Antirotation 2 Versus Proximal Femoral Nail

Abstract Background: Intertrochanteric fractures of the femur commonly occur in elderly osteoporotic individuals. Recumbency post-hip fractures have been related to increased mortality among elderly patients. Surgical treatment is essential in such types of fractures for obtaining a reduction, that is, acceptable as well as for the early rehabilitation of the patients. The dynamic hip screw implant, earlier considered to be the hallmark treatment for stable intertrochanteric fractures, proved inadequate for the fixation of the unstable type of fractures. For the treatment of the unstable variety, a dynamic femoral head/neck stabilization implant coupled with intramedullary nailing is now considered to be ideal. Materials and Methods: Intertrochanteric fracture patients, after meeting inclusion and exclusion criteria, were divided into two groups based on the implant used. The helical blade group and the screw fixation group contained 30 intertrochanteric fracture patients each. After proximal femoral nailing, the clinical and radiological outcomes were compared between proximal femoral nail (PFN) and PFN antirotation 2 (PFNA2) groups based on various parameters, including operative time, intra-operative blood loss, neck-shaft angle, type of reduction, tip apex distance, Cleveland index, Harris Hip Score, and Parker Palmer Mobility score (PPS). Results: Both groups were comparable in terms of age, gender, and AO type. Between the two groups, the helical blade group had lower operative time, less blood loss, better postoperative Harris Hip Score, and PPS. Radiological outcomes were similar in both groups. Conclusion: In conclusion, PFNA2 shows superiority over PFN as it has lesser procedure time, lesser intra-operative blood loss, and better six-month postoperative Harris Hip Score and PPS.