Results of the Proximal Femoral Nail-Antirotation (PFNA) in Patients with an Unstable Pertrochanteric Fracture

Purpose: This study was performed to review the results of PFNA (Proximal Femoral Nail Antirotation) for treating unstable femoral intertrochanteric fractures. Materials and Methods: Forty-seven out of 187 hips treated from September 2006 to March 2010 with PFNA for unstable femoral pertrochanteric fractures were enrolled in this study. The mean duration to radiologic bone union, the functional status and the complications were assessed. The Cleveland index, the tip apex distance, the sliding distance of the blade and the change in the neck-shaft angle were also measured. Results: The mean duration to radiologic bone union was 15.8 weeks and 66% of the patients recovered to a premorbid functional status. The average amount of blade sliding was 5.5 mm and the mean change of the neck-shaft angle was varus 4.4。 . There were 2 cases of penetration of the blade tip, 2 cases of impending penetration, one case of posttraumatic osteonecrosis of the femoral head and 2 cases of lateral wall fractures. Conclusion: PFNA would be preferable for unstable femoral intertrochanteric fractures in terms of the short operation time, the rapid ambulatory recovery and the reduced complications. Yet careful handling is required to avoid a grave complication such as head penetration.