ArticleIndian journal of orthopaedics
PFNA-II protrusion over the greater trochanter in the Asian population used in proximal femoral fractures.
Article in Indian journal of orthopaedics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 26 citations in OpenAlex.
- Article
- Anatomical structure of the medullary cavity of proximal femur with three-dimensional computed tomography.BMC musculoskeletal disorders · 2025Article
- Article
- Article
- Does matching degree matter for proximal femoral intramedullary nail on reoperation rate in intertrochanteric fractures?Journal of orthopaedic surgery and research · 2022Article
- Delayed hematoma in gluteus medius caused by Gamma nail protrusion over the greater trochanter.Trauma case reports · 2021Article
- Which implant is better for beginners to learn to treat geriatric intertrochanteric femur fractures: A randomised controlled trial of surgeons, metalwork, and patients.Journal of orthopaedic translation · 2020Article
- Computer-assisted preoperative planning improves the learning curve of PFNA-II in the treatment of intertrochanteric femoral fractures.BMC musculoskeletal disorders · 2020Article
- The Results of Unstable Intertrochanteric Femur Fracture Treated with Proximal Femoral Nail Antirotation-2 with respect to Different Greater Trochanteric Entry Points.Advances in orthopedics · 2020Article
- Comparison of radiological and functional outcome of unstable intertrochanteric femur fractures treated using PFN and PFNA-2 in patients with osteoporosis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2019Article
- Anteromedial cortical support reduction in unstable pertrochanteric fractures: a comparison of intra-operative fluoroscopy and post-operative three dimensional computerised tomography reconstruction.International orthopaedics · 2018Article
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6 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe treatment of proximal femoral fractures in geriatric osteoporotic patients continues to be a challenge in orthopaedic trauma. Various kinds of cephalomedullary nails, such as gamma nail, InterTan and PFNA were used clinically. The latest generation PFNA II, specially designed for Asian population, is commonly used for geriatric per-/intertrochanteric fractures. The aim of this study was to determine whether the current PFNA-II proximal segment length is suitable for the greater trochanter height, as assessed by postoperative radiograph measurements. MATERIALS AND
methods51 consecutive patients with per-/intertrochanteric fractures treated with the PFNA-II between July 2012 and December 2012 were enrolled in this study. There were 19 males and 32 females, with an average age of 78.6 years (range 66-92 years). According to AO/OTA classification system, there were 4 cases of 31A1 fractures, 35 cases of 31A2 fractures, and 12 cases of 31A3 fractures. The nail protrusion height over the lateral greater trochanter and the Parker ratio of the helical blade tip in the femoral head were measured and compared using pelvic digital anteroposterior radiographs taken within 2 weeks postoperatively. Patients were followed up for a minimum period of 1 year to check whether they had lateral trochanter pain.
resultsPostoperative digital anteroposterior (AP) films were used for assessment and any prominence was recorded as positive. Overall, nail protrusion over the greater trochanter occurred in 87.8% of cases. In 60.8% of the cases, protrusion height was >5 mm. The average protrusion height was 6.25 ± 4.27 mm (male average 4.84 ± 4.38 mm, and female average 7.09 ± 4.70 mm). The average Parker ratio of all cases was 51.0 ± 6.9% (male average 49.8 ± 7.5% and female average 51.7 ± 6.5%). Protrusion height was positively correlated (
conclusionsThere was a morphologic mismatch between the proximal segment length of the PFNA-II and the greater trochanter in the Asian population, which may be the cause of postoperative lateral trochanter pain. A modification to shorten the proximal part of the nail is proposed to avoid protrusion over the greater trochanter.
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