Evaluation of Functional and Radiological Outcomes in Patients with Unstable Intertrochanteric Fractures Treated Using the Proximal Femoral Nail Anti-rotation-2 Implant

Abstract Background: Unstable intertrochanteric fractures, often observed in the elderly and trauma patients, require prompt surgical intervention for optimal outcomes. Proximal femoral nail anti-rotation (PFNA)-2 has emerged as a preferred method due to its biomechanical advantages and minimally invasive nature. This study evaluates the functional outcomes of unstable intertrochanteric fractures managed by PFNA-2 using the modified Harris hip score (HHS), which incorporates culturally relevant activities for the Indian population. Methodology: This prospective observational study was conducted at King George’s Medical University, Lucknow, with ethical approval. Eighty patients aged 40–60 years with unstable intertrochanteric fractures underwent closed reduction and proximal femoral nail (PFN) fixation. Modified HHS was recorded at 1, 3, and 6 months postoperatively to assess outcomes regarding pain, function, range of motion, and deformity absence. Radiological assessments were tracked using the Radiographic Union Score for Hip questionnaire. Results: The mean age was 49.32 ± 6.08 years, with a male-to-female ratio of 11:5. Road traffic accidents were the most common cause of fractures among younger patients. Postoperative complications were observed in 36.25% of cases, out of this 12.5% of cases presented with proximal migration of the screw. At 6 months, 41.25% of patients had excellent outcomes, 38.75% good, 13.75% fair, and 6.25% poor. The mean operative time was 82.46 min, and the average fracture union time was 18.23 ± 2.09 weeks. Conclusion: PFN is a reliable and effective treatment for unstable intertrochanteric fractures, providing consistent functional recovery with minimal complications. Modified HHS proved useful in assessing outcomes, especially in the Indian context. Further research with larger samples and longer follow-ups is warranted.