Comparison of proximal femoral nail antirotation blade and reverse less invasive stabilization system‐distal femur systems in the treatment of proximal femoral fractures

Objective: To compare the effects of proximal femoral nail antirotation blade (PFNA) and reverse less invasive stabilization system‐distal femur (Liss‐DF) systems in the treatment of proximal femoral fractures. Methods: Between June 2007 and October 2009, 41 proximal femoral fractures were treated, 22 with PFNA (group A) and 19 with reverse LISS‐DF plates (group B). The time to starting full weight‐bearing, fracture healing time, functional recovery (Parker and Palmer mobility score), neck‐shaft angle discrepancies with the intact contralateral hip, preoperative American Society of Anesthesiologists (ASA) scores, the operation durations and amount of intraoperative bleeding were recorded and compared. Results: The mean follow‐up period was 11.2 months (range, 10–12 months). Compared with Group A, Group B showed a statistically longer mean time to bear full body weight and heal their fractures, but a smaller neck‐shaft angle discrepancy (all P < 0.05). The groups were similar in ASA score, operation duration, amount of intraoperative bleeding and Parker and Palmer mobility score. Conclusion: Both PFNA and reverse Liss‐DF were satisfactory for the treatment of proximal femoral fractures, but had different advantages. PFNA allowed earlier weight‐bearing and accelerated fracture healing. Reverse Liss‐DF more effectively avoided coxa vara and may be indicated for patients with very severe osteoporosis.