Comparison of Third Generation Proximal Femoral Nails in Treatment of Reverse Oblique Intertrochanteric Fractures

Abstract

Objective: The purpose of the study is to evaluate the treatment results of reverse oblique AO/OTA 31A1 fractures that have highly mechanical instability risk with two third generation intramedullary nails. Methods: Twenty-eight patients (8 men, 20 women) treated by third generation proximal femoral nails {[}proximal femoral anti-rotation (PFNA)(R) or Intertan (R)] followed minimum one year were included. Average age was 65.0 (31-93) years. Clinical and radiological results, screw migration at one year and complications were recorded. Results: Mean operation time was 72.2 and 72.5 minutes, flouroscopy time was 64.4 and 64.7 seconds, mobilisation time was 2.1 and 2.2 days, full weight bearing time was 8.6 and 8.5 weeks, tip-apex distance was 20.1 and 20.2 mm, fracture healing time was 10.5 and 10.2 weeks, Harris hip score at one year was 80.5 and 83.5, neck-shaft angle difference at one year was 1.6 and 1.1 mm, screw migration at one year was found in 10 and 3 patients and mean migration distance was 3.1 and 0.4 mm for PFNA and Intertan nails respectively. No complications recorded that needs secondary intervention. Fracture healing obtained in all patients. Conclusion: Reverse oblique intertrochanteric fractures can be effectively treated with third generation intramedullary nails. More screw migration was seen in PFNA than Intertan nails after the operation in this study.