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

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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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Conflict of interest

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Trauma Surgery and Sports Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    C. Kammerlander, H. Doshi & M. Blauth

  2. Department of Traumatology, Hand-, Plastic-, and Reconstructive Surgery, Center of Surgery, Center of Musculoskeletal Research, University of Ulm, Ulm, Germany

    F. Gebhard & A. Scola

  3. Department of Traumatology, Stadtspital Waid, Zurich, Switzerland

    C. Meier

  4. Department of Orthopedics and Trauma Surgery, SLK Kliniken Heilbronn, Heilbronn, Germany

    W. Linhart

  5. Department of Orthopedics, Hospital Universitarion Rio Hortega, Vallodolid, Spain

    M. Garcia-Alonso & J. Nistal

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  1. C. Kammerlander
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  2. H. Doshi
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  9. M. Blauth
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Correspondence to C. Kammerlander.

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Kammerlander, C., Doshi, H., Gebhard, F. et al. Long-term results of the augmented PFNA: a prospective multicenter trial. Arch Orthop Trauma Surg 134, 343–349 (2014). https://doi.org/10.1007/s00402-013-1902-7

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  • DOI: https://doi.org/10.1007/s00402-013-1902-7

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