• J Penzkofer, T Mendel, C Bauer, and K Brehme.
• Abt. für Unfallchirurgie, Sporttraumatologie und arthroskopische Chirurgie, Zentrum für Erkrankungen der Haltungs- und Bewegungsorgane (ZHBO), Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle, Saale, Deutschland. josef.penzkofer@gmx.de
• Unfallchirurg. 2009 Aug 1; 112 (8): 699-705.

BackgroundCan the helical blade in proximal femur nailing antirotation (PFNA) reach a better bony fixation than proximal femur nailing (PFN), thereby decreasing complication rates and improving clinical outcomes especially in osteoporotic bone?Materials And MethodsIn a retrospective study complications and clinical treatment results of pertrochanteric and subtrochanteric femoral fractures were analyzed. For this purpose a group of patients stabilized with PFN (n=65) were compared to a patient group treated with PFNA (n=66). Objective and subjective parameters were acquired and analyzed by clinical follow-up studies using the Merle d'Aubigné score and X-ray evaluation. Individual bone quality was analyzed radiologically by determining the Singh index. The mean follow-up time was 7 months in each group.ResultsThe PFNA showed a decrease in postoperative implant-associated complications especially in osteoporotic bone and unstable fracture types.ConclusionThe philosophy of the PFNA blade with better fixation through an increased implant-bone-interface and smaller cross-section, compaction of cancellous bone as well as an antirotational fixation, seems to show advantages compared to the double screw system of the PFN.

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