The helical blade of the proximal femoral nail antirotation (PFN-A鈩? achieves better cancellous bone compaction in the femoral neck, thereby decreasing the risk of secondary displacement.
We retrospectively reviewed consecutive cases of PFN-A鈩?fixation performed between 2006 and 2008 in 102 patients (75 females and 27 males) with a mean age of 84.9 卤 9.5 years (range, 70-100 years). Functional outcomes were assessed using the Parker Mobility Score.
Mean follow-up in the 102 patients was 21.3 卤 17.5 months (4-51 months). Fracture distribution in the AO classification scheme was A1, n = 45; A2, n = 41; and A3, n = 16. At last follow-up, Parker Mobility Score values in the 65 survivors were 0-3, n = 35; 4-6, n = 11; and 7-9, n = 19. Fracture union was consistently achieved, after a mean of 10.3 卤 3 weeks. Blade back-out allowed by the device design occurred in 16 (15.7%) patients but caused pain due to screw impingement on the fascia lata in only five patients (of whom two underwent reoperation). Cephalic blade cut-out was noted in three (2.9%) patients, of whom one required reoperation because of acetabular penetration. Two hardware-related fractures were recorded.
The new PFN-A鈩?device ensures reliable fixation with low mechanical complication rates. Although our data do not constitute proof that a helical blade is superior over a neck screw, they suggest a decreased rate of construct failure and may serve as a basis for a comparative study.
Level IV, retrospective study.