Abstract
OBJECTIVE: To compare the early outcomes of proximal femoral nail antirotation (PFNA) and new proximal femoral nail antirotation (PFNA-Pro) in the treatment of elderly patients with intertrochanteric fractures complicated with lateral wall fractures. METHODS: The clinical data of elderly patients with intertrochanteric fractures accompanied by lateral wall fractures treated in the Affiliated Hospital of Qingdao University, Qingdao, China from March 2024 to October 2024 were retrospectively analyzed. Patients were divided into two groups according to different intramedullary fixation techniques. One group was fixed with PFNA intramedullary fixation technique (n = 20), and the other group was fixed with PFNA Pro intramedullary fixation technique (n = 22). The preoperative general data, operation time, intraoperative blood loss, weight-bearing time, neck-shaft angle, tip-apex distance (TAD), and postoperative hip joint range of motion and function score were compared between the two groups. RESULTS: There were no significant differences in gender, age, injured side, injury cause, operation time, intraoperative blood loss, neck-shaft angle and TAD between the two groups (P > 0.05). The weight-bearing time of lower limbs in PFNA Pro group was earlier than that in PFNA group (P < 0.05). The Harris Hip Score (HHS) at 1 month postoperatively was higher in patients in the PFNA-Pro group than in the PFNA group (p < 0.05), and there were no significant differences in the HHS at 3 and 6 months postoperatively and the Parker-Palmer Mobility Score (PPMS) at 6 months postoperatively (p > 0.05). CONCLUSIONS: PFNA-Pro, as an improved modality of PFNA, provides a new idea for the treatment of elderly intertrochanteric femur fractures with lateral wall fractures, and it is superior to the PFNA intramedullary fixation technique in accelerating early weight-bearing and promoting functional recovery of the hip.