Analysis of the effect of PFNA in the treatment of femoral intertrochanteric fracture with or without lateral wall injury

Objective To analyze and explore whether the effect of proximal femoral nail antirotation (PFNA) in the treatment of intertrochanteric fracture of femur (IFF) is related to the integrity of the lateral wall of the femur.

Methods The clinical data of IFF patients treated with PFNA were analyzed retrospectively. The patients were divided into two groups: intact lateral wall group (group A) and injured lateral wall group B (including iatrogenic lateral wall injury). The baseline, intraoperative and postoperative data of the two groups were collected, and the data differences between the two groups were compared to explore the relationship between lateral wall integrity and the effect of PFNA.

Results There was no significant difference in baseline data and TAD value between the two groups (P>0.05). There was a significant difference in intraoperative bleeding, operation time, incision length, incidence of complications, and excellent rate of Harris hip function score at 6 and 12 months after operation between the two groups (P<0.05 to P<0.01).

Conclusions The effect of PFNA surgery for IFF is closely related to the condition of the lateral wall, with better surgical results in the group with an intact lateral wall than in the group with a damaged lateral wall. The lateral wall should be actively protected to avoid medically-induced injury during surgery.