The AO/ASIF proximal femoral nail antirotation (PFNA): A new design for the treatment of unstable proximal femoral fractures

Introduction: PFNA design compacts the cancellous bone to provide increased stability and has been biomechanically proven to retard rotation and varus collapse. Methods: Between 2006 and 2007, 62 consecutive patients with unstable proximal femoral fractures were treated with the PFNA. Results: Twenty males and 42 females with a mean age of 78 years (44-94) were reviewed. In 48 patients, the fracture resulted from a low energy injury. The majority of the fractures belonged to AO/ASIF types 31A2.3 (22) and 31A3.2 (29). Twelve patients required open reduction. The PFNA blade position was central in 52 patients with a mean tip-apex distance (TAD) of 12 mm (range 4-34 mm). Post-operatively, five patients died within 3 months and two patients were lost to follow-up. Forty-nine fractures united between 3 and 4 months. Four patients had delayed union. The PFNA blade cut out rate was 3.6%. Conclusions: Unstable proximal femoral fractures were treated successfully with the PFNA. The PFNA blade appears to provide additional anchoring in osteoporotic bone. No results have been published on this new design. (C) 2008 Elsevier Ltd. All rights reserved.