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Title: Functional Outcomes, Operating Time, Bleeding Rate and Weight Bearing in Short Vs Long PFNA in IT Femur Fracture
Authors: Muhammad Shoaib, Asad Moiz Hussain, Muhammad Nadeem, Najeeb Tareen, Ahmed Mushtaq Khan, Azhar Yasin
Journal: Indus Journal of Bioscience Research (IJBR)
| Category | From | To |
|---|---|---|
| Y | 2024-10-01 | 2025-12-31 |
Publisher: Indus Education and Research Network
Country: Pakistan
Year: 2024
Volume: 2
Issue: 2
Language: English
Keywords: Proximal Femoral Nail Antirotation (PFNA)Intertrochanteric Femur FractureOperating TimeBleeding RateWeight-bearingFunctional Outcomes
Objective: In order to manage intertrochanteric (IT) femur fractures, this study compares the functional outcomes, operating time, bleeding rate, and weight-bearing capability using short and long proximal femoral nail antirotation (PFNA). Methods: Patients who received PFNA for IT femur fractures between April and September of 2024 were the subjects of a retrospective investigation. Based on the length of the PFNA used, sixty patients were split into two groups: thirty received a short PFNA and thirty received a long PFNA. The time it took to reach full weight-bearing, operating time, intraoperative bleeding rate, and functional results as measured by the Harris Hip Score (HHS) at 6 and 12 weeks were among the important factors assessed. A statistical analysis was performed on the data to identify any noteworthy variations between the two groups. Results: There were 60 patients in the trial; 30 were in the long PFNA group and 30 were in the short PFNA group. The short PFNA group had an average operating duration of 45 minutes, which was considerably less than the long PFNA group's 65 minutes (p<0.05). The short PFNA group experienced a considerably lower intraoperative blood loss (average of 140 ml) than the long PFNA group (average of 210 ml) (p<0.05). The HHS's measure of functional outcomes showed no statistically significant difference in scores at 12 weeks (p=0.65) between the two groups. There was no discernible difference in the recovery period between the two groups' average time to reach full weight-bearing, which was 8 weeks. The lengthy PFNA group had slightly fewer complications, such as fixation failure, but the difference was not statistically significant (p=0.58). Conclusion: Reduced operating time and less intraoperative bleeding are two benefits of short PFNA, without sacrificing weight-bearing ability or functional results. While both short and long PFNA offer comparable functional outcomes, addressing IT femur fractures may benefit more from short PFNA's potential for greater effectiveness and safety. Additional investigation, including prospective studies, is important to corroborate these results and evaluate enduring consequences.
To compare the functional outcomes, operating time, bleeding rate, and weight-bearing capability of short versus long Proximal Femoral Nail Antirotation (PFNA) in the management of intertrochanteric (IT) femur fractures.
Retrospective cohort study involving 60 patients with IT femur fractures treated with PFNA between April and September 2024. Patients were divided into two groups: 30 received short PFNA and 30 received long PFNA. Data collected included operating time, intraoperative bleeding rate, time to full weight-bearing, and functional outcomes measured by the Harris Hip Score (HHS) at 6 and 12 weeks. Statistical analysis (t-tests, chi-square tests) was used to compare groups, with a p-value < 0.05 considered significant.
graph TD;
A[Patient Selection IT Femur Fractures] --> B[Retrospective Cohort Design];
B --> C[Group Assignment: Short PFNA n=30 vs. Long PFNA n=30];
C --> D[Data Collection: Operating Time, Blood Loss, Weight Bearing, HHS];
D --> E[Statistical Analysis t-tests, Chi-square];
E --> F[Comparison of Outcomes];
F --> G[Conclusion on Efficacy and Safety];
Shorter operating times and reduced blood loss with short PFNA are clinically significant, potentially leading to fewer perioperative complications and improved recovery, especially in elderly patients. While long PFNA may offer more biomechanical stability, the study found no significant difference in functional outcomes or weight-bearing capacity. Both short and long PFNA appear to be safe and effective for IT femur fractures, with short PFNA offering advantages in surgical efficiency and blood loss.
The short PFNA group had a significantly shorter operating time (45.3 minutes) and lower intraoperative blood loss (140.2 mL) compared to the long PFNA group (65.6 minutes and 210.8 mL, respectively) (p<0.001 for both). There were no statistically significant differences in functional outcomes (HHS at 6 and 12 weeks) or time to full weight-bearing (approximately 8 weeks) between the two groups. Complication rates were comparable, with no significant differences observed.
Short PFNA is a safe and effective option for treating intertrochanteric femur fractures, offering reduced operating time and intraoperative bleeding without compromising functional outcomes, weight-bearing ability, or complication rates compared to long PFNA. Further prospective studies are recommended to evaluate long-term consequences.
1. Operating Time: Short PFNA group averaged 45.3 minutes, significantly less than the long PFNA group's 65.6 minutes (p<0.001).
2. Intraoperative Blood Loss: Short PFNA group averaged 140.2 mL, significantly less than the long PFNA group's 210.8 mL (p<0.001).
3. Functional Outcomes (HHS at 12 weeks): No statistically significant difference between short PFNA (79.4 ± 10.2) and long PFNA (78.1 ± 11.5) groups (p=0.65).
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