PFN A3 in Intertrochanteric Fractures: A Game Changer in Proximal Femoral Fixation
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Abstract
Background: Intertrochanteric fractures, unstable particularly (AO/OTA 31-A3), is difficult to treat. Proximal femoral nailing (PFN) has emerged as a convenient means of its treatment owing to biomechanical superiority to achieve optimal stability and minimizing complications, particularly comminuted or osteoporotic fractures. This article explores the effectiveness of a PFN A3 design in the treatment of intertrochanteric fractures. To assess the clinical and radiologic results of the use of the PFN A3 for fixation of intertrochanteric fractures, particularly in the stability of fixation, fracture union, and complication reduction. Material & Methods: In this retrospective analysis, 158 patients (48 men, 110 women; age range, 47-95 years) who had surgical fixation with the PFN A3 for intertrochanteric fractures from September 2022 to April 2025 were studied. Seventy-five fractures were on the right side and 83 on the left side. Fracture classification, operative time, blood loss, union rate, time to weight-bearing, and complications were recorded and compared. Results: The mean age of the study population was 78.3 years, with a slight female predominance (69.62%). The distribution of Modified Harris Hip Score (MHHS) among study participants revealed significant variations with age, while differences based on sex and AO/OTA classification were not statistically significant, with 26% of patients categorized as having good outcomes and 36% classified as excellent. Younger patients demonstrated significantly better functional outcomes. The mean neck–shaft angle was 137°, with no significant variation across demographic groups. The mean TAD was 21.09 mm. Post-operative complications were minimal, with screw cut-out occurred in no cases and superficial wound healing delays in 0.17%, sepsis in 1.26%. Conclusion: For intertrochanteric fractures PFN A3 implant plays a significant role as far as femoral fixation especially in older individuals due to the osteoporotic nature of the bone in elderly patients.
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Copyright (c) 2025 Vinay Kumar, Sajjad Ali, Dibin DK, Mohammed Irshad P M, Mohamed Nafsal Velakadu Navasali, Peeyush Rawat, Jamila Hameed
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Vinay Kumar, Faculty of Department of Orthopaedics, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Faculty of Department of Orthopaedics, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Sajjad Ali, Faculty of Department of Orthopaedics, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Faculty of Department of Orthopaedics, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Dibin DK, Faculty of Department of Orthopaedics, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Faculty of Department of Orthopaedics, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Mohammed Irshad P M, Faculty of Department of Orthopaedics, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Faculty of Department of Orthopaedics, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Mohamed Nafsal Velakadu Navasali, CRMI, Karuna Medical College Hospital, Vilayodi, Palakkad, Kerala, 678103, India.
CRMI, Karuna Medical College Hospital, Vilayodi, Palakkad, Kerala, 678103, India.
Peeyush Rawat, CRMI, Karuna Medical College Hospital, Vilayodi, Palakkad, Kerala, 678103, India.
CRMI, Karuna Medical College Hospital, Vilayodi, Palakkad, Kerala, 678103, India.
Jamila Hameed, Research Mentor, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Research Mentor, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
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