HALF OF ALL HIP FRACTURES COMPRISE OF INTERTROCHANTERIC FEMUR FRACTURES. INTERTROCHANTERIC FRACTURES OCCUR MOST COMMONLY IN ELDERLY PATIENTS AND THE OUTCOME MAY BE COMPROMISED IF THE PATIENTS ARE NOT MOBILIZED EARLY. THE BEST TREATMENT FOR INTERTROCHANTERIC FRACTURE REMAINS CONTROVERSIAL. MANY METHODS HAVE BEEN RECOMMENDED. INTERNAL FIXATION IS THE MOST COMMON SURGICAL TREATMENT FOR INTERTROCHANTERIC FRACTURES, AND INTRA-MEDULLARY (NAILS) AND EXTRA-MEDULLARY  (SCREWS OR PLATES) FIXATIONS ARE TWO COMMONLY USED IMPLANTS OR APPLIANCES. THE PFNA-II BY USING A SINGLE HELICAL BLADE WAS DESIGNED TO ACHIEVE 

BETTER STABILIZATION OF THE INTERTROCHANTERIC FRACTURES RATHER THAN A SCREW SYSTEM OR DOUBLE SCREW FIXATION LIKE IN PFN FOR FIXATION. THE HELICAL BLADE INCREASES THE BONE-IMPLANT INTERFACE AND RESULT IN COMPACTION OF CANCELLOUS  BONE, THEREBY PROVIDING EXCELLENT STABILITY OF FIXATION. 

MATERIALS AND METHODS: 

A RANDOMIZED CONTROLLED TRIAL OF 60 PATIENTS CARRIED OUT IN DEPARTMENT OF ORTHOPAEDICS OF TERTIARY CARE TEACHING HOSPITAL WAS DONE. ALL ELDERLY PATIENTS GETTING ADMITTED WITH INTERTROCHANTERIC FRACTURES FULFILLING THE INCLUSION CRITERIA WERE TREATED WITH CLOSED REDUCTION AND INTERNAL FIXATION 30 IN EACH GROUP WITH PROXIMAL FEMORAL NAIL GROUP AND PROXIMAL FEMORAL NAIL ANTIROTATION-II AFTER RANDOMIZATION OF PATIENTS. RESULTS: FUNCTIONAL OUTCOME OF EVERY PATIENT WAS ASSESSED WITH BLOOD LOSS, OPERATIVE TIME, RADIATION EXPOSURE, HARRIS HIP SCORE, TIME OF WEIGHT BEARING AT 1MONTH, 3 MONTHS AND 6 MONTHS FOLLOW-UP. OUR STUDY DEMONSTRATES SIGNIFICANT DIFFERENCE BETWEEN OPERATIVE TIME, BLOOD LOSS, RADIATION EXPOSURE AND MEAN HHS, WEIGHT BEARING AT 6 MONTH AFTER SURGERY BETWEEN PFNA-II AND PFN GROUP. 

CONCLUSION:

FROM OUR STUDY WE CAN SAFELY CONCLUDE THAT OSTEOSYNTHESIS WITH 

PROXIMAL FEMORAL NAIL ANTIROTATION-II IN INTERTROCHANTERIC FEMUR FRACTURE IN THE ELDERLY PATIENTS LEADS TO BETTER FUNCTIONAL OUTCOMES AS COMPARED WITH OSTEOSYNTHESIS WITH PROXIMAL FEMORAL NAIL. WE CAN SAFELY CONSIDER IT AS A VIABLE OPTION IN THE TREATMENT OF INTERTROCHANTERIC FRACTURES IN THE ELDERLY.