{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T15:46:56Z","timestamp":1782834416814,"version":"3.54.5"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AOTT"],"abstract":"<jats:p>Abstract\n\nObjectives: We evaluated the radiographic and functional results of the proximal femoral nail antirotation (PFNA) system in patients with unstable intertrochanteric femoral fractures.\\r\\nMethods: The study included 45 patients (25 women, 20 men; mean age 72 years; range 27 to 97 years) who underwent osteosynthesis using the PFNA for unstable intertrochanteric femoral fractures. The fractures were in the right hip in 25 patients, and in the left hip in 20 patients. The fractures were classified according to the AO system. One patient had an open fracture due to firearm injury (Gustilo-Anderson 3A). The patients underwent surgery within a mean of eight days (range 2 to 21 days) from injury. The mean hospital stay was 13.5 days (range 4 to 25 days). Closed reduction was achieved in all the patients. The results were assessed clinically and radiographically. The neck-shaft angle of the femur (collodiaphysial angle) and the tip-apex distance were measured. The position of the helical screw within the femoral head was determined using the method of Cleveland and Bosworth. Clinical evaluation was made using the Harris hip score. Perioperative and postoperative complications were recorded. The mean follow-up period was 17.3 months (range 6 to 23 months).\\r\\nResults: The mean operation time was 37.8 min (range 22 to 118 min) and the mean blood loss was 225 ml (range 150 to 450 ml). During surgery, femoral shaft fracture occurred in three patients, and greater trochanter fracture occurred in nine patients. Union was obtained in all the patients. Reduction was poor in four patients (8.9%), acceptable in seven patients (15.6%), and good in 34 patients (75.6%). The mean collodiaphysial angle was 136.7\u00b0 (range 125\u00b0 to 148\u00b0). The tip-apex distance was &lt;25 mm in 36 patients (80%), and ?25 mm in nine patients (20%). The position of the helical screw in the femoral head was appropriate in 38 patients (84.4%). Postoperative complications included secondary varus (n=2, 4.4%), calcification at the tip of the greater trochanter (n=7, 15.5%), sensitivity over the fascia lata (n=7), medial thigh pain (n=11, 24.4%), and screw cut-out (n=1, 2.2%). Nine patients developed femoral shortness (mean 9.4 mm; range 8 to 13 mm). Screws showed lateral displacement in five patients (11.1%), which was less than 5 mm in four patients. Secondary surgery was required in four patients (8.9%). The mean Harris hip score was 77.8. Harris hip scores were very good in 11 patients (24.4%), good in 19 patients (42.2%), moderate in nine patients (20%), and poor in six patients (13.3%).\\r\\nConclusion: Due to advantages of high union rate, early postoperative mobilization, and short operation time, PFNA osteosynthesis is the method of choice for surgical treatment of unstable intertrochanteric femoral fractures.\n\n\n\u00d6zet\n\nAma\u00e7: Stabil olmayan intertrokanterik femur k\u0131r\u0131 nedeniyle proksimal femoral \u00e7ivi antirotasyon (PFNA) uygulanan hastalar\u0131n radyografik ve fonksiyonel sonu\u00e7lar\u0131 de\u011ferlendirildi.\\r\\n\u00c7al\u0131\u015fma plan\u0131: \u00c7al\u0131\u015fmaya stabil olmayan intertrokanterik k\u0131r\u0131k tan\u0131s\u0131yla PFNA \u00e7ivisiyle osteosentez uygulanan 45 hasta (25 kad\u0131n, 20 erkek; ort. ya\u015f 72; da\u011f\u0131l\u0131m 27-97) al\u0131nd\u0131. Yirmi be\u015f hastan\u0131n sa\u011f, 20 hastan\u0131n sol kal\u00e7as\u0131nda intertrokanterik k\u0131r\u0131k vard\u0131. K\u0131r\u0131klar AO s\u0131n\u0131flamas\u0131na g\u00f6re s\u0131n\u0131fland\u0131r\u0131ld\u0131. Bir hastada ate\u015fli silah yaralanmas\u0131 sonucu geli\u015fen a\u00e7\u0131k k\u0131r\u0131k (Gustilo-Anderson 3A) vard\u0131. Hastalar travma tarihinden itibaren ortalama sekizinci g\u00fcnde (da\u011f\u0131l\u0131m 2-21 g\u00fcn) ameliyat edildi. Hastalar\u0131n hastanede kal\u0131\u015f s\u00fcresi ortalama 13.5 g\u00fcnd\u00fc (da\u011f\u0131l\u0131m 4-25 g\u00fcn). Hastalar\u0131n t\u00fcm\u00fcnde red\u00fcksiyon kapal\u0131 olarak ger\u00e7ekle\u015ftirildi. Sonu\u00e7lar klinik ve radyografik olarak de\u011ferlendirildi. Boyun-cisim a\u00e7\u0131s\u0131 (kollodiyafizer a\u00e7\u0131) ve implant ucu-femur ba\u015f\u0131 apeks mesafesi \u00f6l\u00e7\u00fcld\u00fc. Helikal vidan\u0131n femur ba\u015f\u0131 i\u00e7indeki konumu, Cleveland ve Bosworth\u2019un tan\u0131mlad\u0131\u011f\u0131 y\u00f6ntem ile belirlendi. Klinik de\u011ferlendirmede Harris kal\u00e7a skoru kullan\u0131ld\u0131. Ameliyat s\u0131ras\u0131nda ve sonras\u0131nda geli\u015fen komplikasyonlar kaydedildi. Ortalama takip s\u00fcresi 17.3 ay (da\u011f\u0131l\u0131m 6-23 ay) idi.\\r\\nSonu\u00e7lar: Ortalama ameliyat s\u00fcresi 37.8 dakika (da\u011f\u0131l\u0131m 22-118 dk), ortalama kan kayb\u0131 225 ml (da\u011f\u0131l\u0131m 150-450 ml) bulundu. Ameliyat s\u0131ras\u0131nda \u00fc\u00e7 hastada femur cisim k\u0131r\u0131\u011f\u0131, dokuz hastada b\u00fcy\u00fck trokanter k\u0131r\u0131\u011f\u0131 geli\u015fti. Takip d\u00f6nemi i\u00e7inde t\u00fcm k\u0131r\u0131klar sorunsuz olarak kaynad\u0131. D\u00f6rt hastada (%8.9) k\u00f6t\u00fc, yedi hastada (%15.6) kabul edilebilir, 34 hastada (%75.6) iyi red\u00fcksiyon sa\u011fland\u0131\u011f\u0131 g\u00f6r\u00fcld\u00fc. Kollodiyafizer a\u00e7\u0131 ortalamas\u0131 136.7\u00b0 (da\u011f\u0131l\u0131m 125\u00b0-148\u00b0) \u00f6l\u00e7\u00fcld\u00fc. Tepe-apeks mesafesi 36 hastada (%80) &lt;25 mm, dokuz hastada (%20) ?25 mm bulundu. Otuz sekiz olguda (%84.4) helikal vidan\u0131n femur ba\u015f\u0131 i\u00e7indeki konumu uygundu. Takip d\u00f6nemi i\u00e7inde iki hastada (%4.4) ikincil varus, yedi hastada (%15.5) trokanter maj\u00f6r ucunda kalsifikasyon, yedi hastada (%15.5) fasya lata \u00fczerinde hassasiyet, 11 hastada (%24.4) uyluk medialinde a\u011fr\u0131, bir hastada (%2.2) s\u0131yr\u0131lma g\u00f6r\u00fcld\u00fc. Dokuz hastada femurda ortalama 9.4 mm (da\u011f\u0131l\u0131m 8-13 mm) k\u0131sal\u0131k geli\u015fti. Vidan\u0131n laterale kaymas\u0131 be\u015f hastada (%11.1) g\u00f6r\u00fcld\u00fc; bunlar\u0131n d\u00f6rd\u00fcnde kayma 5 mm\u2019nin alt\u0131nda idi. D\u00f6rt hastada (%8.9) ikincil ameliyat gerekti. Klinik de\u011ferlendirmede Harris kal\u00e7a skoru ortalamas\u0131 77.8 bulundu. Harris kal\u00e7a skoru 11 hastada (%24.4) \u00e7ok iyi, 19 hastada (%42.2) iyi, dokuz hastada (%20) orta, alt\u0131 hastada (%13.3) k\u00f6t\u00fc idi. \\r\\n\u00c7\u0131kar\u0131mlar: Stabil olmayan intertrokanterik femur k\u0131r\u0131klar\u0131n\u0131n cerrahi tedavisinde PFNA osteosentezi, y\u00fcksek kaynama oran\u0131, stabil tespit sonras\u0131 erken d\u00f6nemde harekete izin vermesi ve ameliyat s\u00fcresinin k\u0131sa olmas\u0131ndan dolay\u0131 \u00f6ncelikle tercih edilmesi gereken bir y\u00f6ntemdir.<\/jats:p>","DOI":"10.3944\/aott.2010.2237","type":"journal-article","created":{"date-parts":[[2010,11,28]],"date-time":"2010-11-28T10:22:18Z","timestamp":1290939738000},"page":"127-134","source":"Crossref","is-referenced-by-count":32,"title":["Radiographic and functional results of osteosynthesis using the proximal femoral nail antirotation PFNA in the treatment of unstable intertrochanteric femoral fractures"],"prefix":"10.5152","volume":"44","author":[{"given":"Suner","family":"Sahin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erden","family":"Erturer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irfan","family":"Ozturk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serdar","family":"Toker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faik","family":"Seckin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senol","family":"Akman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3111","published-online":{"date-parts":[[2020,2,8]]},"container-title":["Acta Orthopaedica et Traumatologica Turcica"],"original-title":[],"link":[{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/download\/2370\/2327","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:56:36Z","timestamp":1763463396000},"score":1,"resource":{"primary":{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/view\/2370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,8]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2010,1,2]]}},"URL":"https:\/\/doi.org\/10.3944\/aott.2010.2237","relation":{},"ISSN":["2589-1294","1017-995X"],"issn-type":[{"value":"2589-1294","type":"electronic"},{"value":"1017-995X","type":"print"}],"subject":[],"published":{"date-parts":[[2020,2,8]]}}}