Proximal femoral nail anti-rotation (PFNA) to treat peritrochanteric fractures in elderly patients

The treatment of peritrochanteric fractures in elderly patients with osteoporosis due to the difficulty of obtaining and maintaining stable fixation. Although many implants have been developed to solve this problem, the choice of implant has been controversial. We present 71 consecutive peritrochanteric fractures treated with proximal femoral nail anti-rotation (PFNA). The average age of the patients was 80.75 ± 6.42 (71–96) years. The fractures were closely reduced and fixed with PFNA. All of the fractures healed in an average of 14 weeks. The mean operation time was 44.68 ± 8.44 (30–73) minutes, and the mean blood loss was 126.77 ± 49.04 (50–300) ml. One patient was reoperated because of a poor blade position. In three patients, a lateral cortex fracture was observed, and, in one patient, a greater trochanter fracture was observed. At the time of the final follow-up, 78.7% of the patients returned to their pre-injury activity levels. PFNA might be one treatment choice to solve the mechanical problems associated with these fractures because of its improved fixation strength, simpler technique, shorter operation time and reduced blood loss.