Abstract
Introduction:
Intertrochanteric fractures are commonly encountered in elderly population. Nearly half of the fractures are unstable. Surgical fixation is mostly preferred due to early mobilization and to avoid complications of conservative treatment. Unsatisfactory results with extramedullary fixation led to the rise of intramedullary devices. Our aim in this study is to analyze the effectiveness and pitfalls of Proximal Femoral Nail Antirotation (PFNA) in the treatment of unstable intertrochanteric fractures.
Methods:
This prospective study was conducted during October 2017 to January 2019 in our hospital. A total of 20 patients (13 males, 7 females) above 50 years of age having unstable intertrochanteric fracture were treated with Proximal Femoral Nail Antirotation. About 75% of injuries occurred due to trivial fall. Mean interval between trauma and surgery was 3.95 days. All patients were treated by closed reduction. The study participants were followed up for a minimum duration of six months and were assesed using Harris Hip Score.
Results:
Anatomical reduction was achieved in 16 patients. Post operative complications include superficial infection, lag screw back out, delayed union in one case. The average time of union was 14.6 weeks. By the end of six months, good to excellent results were seen in 80% of patients. 75% patients returned to pre injury functional level.
Conclusions:
PFNA gives optimal fixation for Intertrochanteric fractures, with good preoperative planning and intraoperative reduction. It’s the ideal implant for osteoporotic elderly population as it provides good cancellous bone compaction, less operative time and blood loss when compared to other fixation methods.

Key words: Intertrochanteric Fractures, Proximal Femoral Nail Antirotation, Harris Hip Score