A comparison of the proximal femoral nail antirotation device and dynamic hip screw in the treatment of unstable pertrochanteric fracture

J Int Med Res. 2010 Jul-Aug;38(4):1266-75. doi: 10.1177/147323001003800408.


This prospective randomized study compared the outcome of elderly patients with an unstable pertrochanteric fracture, treated with a proximal femoral nail antirotation device (PFNA; n = 51) or a dynamic hip screw (DHS; n = 55). All patients in the DHS group and nine in the PFNA group had open reductions. Incisions were significantly shorter for the PFNA than the DHS group. Blood loss and the number of patients requiring post-operative blood transfusions were significantly greater, but operation and fluoroscopy times were significantly shorter, for the DHS versus the PFNA group. Time to mobilization with a frame was significantly shorter in the PFNA group, and post-operative complications were more common in the DHS group. Poor fracture reduction led to three revisions. All fractures in both groups united during follow-up. The PFNA allowed earlier mobilization and faster recovery than the DHS. The PFNA is a highly acceptable, minimally invasive implant for unstable fractures.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Bone Nails*
  • Bone Screws*
  • Female
  • Femoral Fractures / diagnostic imaging
  • Femoral Fractures / surgery*
  • Femur / diagnostic imaging
  • Femur / pathology*
  • Femur / surgery*
  • Follow-Up Studies
  • Fracture Fixation, Intramedullary / adverse effects
  • Fracture Fixation, Intramedullary / instrumentation*
  • Humans
  • Intraoperative Care
  • Male
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Radiography