Background: Intertrochanteric and subtrochanteric fractures are typically treated with proximal femoral nails. Proximal femoral nails come in two types: regular PFN (which consists of 2 proximal screws) and PFNA2 (which consists of a single proximal screw).
Aim: The aim of our study is to compare functional outcomes and implant-related complications in patients treated with regular PFN versus PFNA2 for intertrochanteric and subtrochanteric fractures.
Material and Methods: A prospective observational and randomized study was conducted with a total of 40 patients with intertrochanteric and subtrochanteric femoral fractures admitted to Bhaskar Medical College Hospital. After fulfilling the inclusion criteria, the patients were divided into two groups randomly, with 20 cases in each group. They were treated with regular PFN and PFNA2, respectively.
Conclusion: Based on the study, we concluded that PFNA2 reduces surgery time, blood loss, and radiation exposure compared to regular PFN. PFNA2 also has a higher union rate with significantly better functional outcomes compared to regular PFN. Patients treated with PFNA2 can bear weight early. Implant-related complications such as screw backing out and cut-through of screws in the femoral head (z-effect and reverse z-effect) are not observed with PFNA2. Therefore, we conclude that PFNA2 is superior to regular PFN.
