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Archives of Orthopaedic and Trauma Surgery

Erschienen in:

01.03.2014 | Trauma Surgery

Long-term results of the augmented PFNA: a prospective multicenter trial

verfasst von: C. Kammerlander, H. Doshi, F. Gebhard, A. Scola, C. Meier, W. Linhart, M. Garcia-Alonso, J. Nistal, M. Blauth

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 3/2014

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Abstract

Background

Pertrochanteric fractures are increasing and their operative treatment remains under discussion. Failures needing reoperations such as a cut-out are reported to be high and are associated with multiple factors including poor bone quality, poor fracture reduction and improper implant placement. The PFNA^® with perforated blade offers an option for standardized cement augmentation with a PMMA cement to provide more stability to the fracture fixation. It remains unclear if the augmentation of this implant does any harm in a longer time span. This prospective multicenter study shows clinical and radiological results with this implant with a mean follow-up time of 15 months.

Methods

In 5 European clinics, 62 patients (79 % female, mean age 85.3 years) suffering from an osteoporotic pertrochanteric fracture (AO 31) were treated with the augmented PFNA^®. The primary objectives were assessment of activities of daily living, pain and mobility. Furthermore, the X-rays were analyzed for the cortical thickness index, changes of the trabecular structure around the cement and the hip joint space.

Results

The mean follow-up time was 15.3 months. We observed callus healing in all cases. The surgical complication rate was 3.2 % with no complication related to the cement augmentation. A mean volume of 3.8 ml of cement was injected and no complication was reported due to this procedure. 59.9 % reached their prefracture mobility level until follow-up. The mean hip joint space did not change significantly until follow-up and there were no signs of osteonecrosis in the follow-up X-rays. Furthermore, no blade migration was assessed.

Conclusion

This study makes us believe that the standardized augmentation of the PFNA with a perforated blade is a safe method to treat pertrochanteric femoral fractures. It leads to good functional results and is not associated with cartilage or bone necrosis.

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Titel: Long-term results of the augmented PFNA: a prospective multicenter trial
verfasst von: C. Kammerlander
H. Doshi
F. Gebhard
A. Scola
C. Meier
W. Linhart
M. Garcia-Alonso
J. Nistal
M. Blauth
Publikationsdatum: 01.03.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 3/2014
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-013-1902-7

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Long-term results of the augmented PFNA: a prospective multicenter trial