THE SHORT TERM OUTCOME OF SUBTROCHANTERIC FRACTURES TREATED WITH THE NEW SYNTHES PROXIMAL FEMORAL NAIL ANTIROTATION (PFNA)

Abstract

Introduction: The PFNA device was developed to address problems of rotational instability in proximal femoral fractures whilst simultaneously employing a single femoral neck element.

Study Design: Prospective cohort.

Methods: All subtrochanteric fractures(AO31A3) admitted to the department were treated with the PFNA and specified data was recorded.

Results: From April 2006 to June 2007, 62 patients were included in the study.4 month follow up has been completed in 30 patients(77% of those available).11 are awaiting follow up and 12 died.The mean age was 79.9 years.

1 patient with a short PFNA nail sustained a fracture of the femur through the site of the distal locking bolt during the follow up period and required revision.

The mobility and social function scores were significantly reduced at follow up compared to pre-operative status(p=0.001).All domains of SF36 were low compared to normative data.

All 30 fractures united and there was no migration, lysis around or cut out of the helical blade.In total, 46 distal locking bolts were utilised.4 of these had migrated or become loose.

Conclusions: Subtrochanteric fractures in the elderly are a devastating injury. Patients do not return to pre-fracture function at 4 months post injury. Early results suggest that the PFNA appears to work well.