@article{article_1697385, title={IMPACT OF THE PROXIMAL FRACTURE STARTING ORIGIN ON THE REDUCTION QUALITY AND COMPLICATIONS IN AO/OTA 31-A2 INTERTROCHANTERIC FEMORAL FRACTURES TREATED WITH PROXIMAL FEMORAL NAIL ANTIROTATION}, journal={Journal of Istanbul Faculty of Medicine}, volume={88}, pages={280–287}, year={2025}, DOI={10.26650/IUITFD.1697385}, author={Kızılkurt, Taha and Demirel, Mehmet and Demir, Bedirhan and Polat, Gökhan and Akgül, Turgut and Erşen, Ali}, keywords={Komplikasyon, kırık başlangıç noktası, proksimal femoral çivi antirotasyonu (PFNA), redüksiyon kalitesi, stabil olmayan intertrokanterik femur kırıkları}, abstract={Objective: This study aimed to investigate the impact of the proximal fracture starting location relative to the tip of the greater trochanter on the reduction quality and complication rates in patients with AO/OTA 31-A2 intertrochanteric femoral fractures (IFFs) treated with Proximal Femoral Nail Antirotation (PFNA). Material and Methods: A retrospective analysis was conducted on 125 patients diagnosed with unstable AO/OTA 31-A2 IFFs treated by PFNA. The fractures were categorised into two subtypes based on the location of the proximal starting point of the fracture line rela tive to the tip of the greater trochanter: subtype 1 (medial or at the tip of the greater trochanter) or subtype 2 (lateral). The quality of reduction was assessed using the Baumgaertner reduction quality criteria, and complication rates, including lateral cortex fractures and blade cut-outs, were compared between the groups. Results: Patients whose fractures originated medially (subtype 1) demonstrated significantly better reduction quality (78% good re duction) compared with those with lateral starting points (subtype 2) (30% good reduction). Additionally, the lateral cortex fracture rate was significantly higher in subtype 2 (16%) than in subtype 1 (0%) (p<0.001). The blade cut-out rate was also higher in subtype 2 (11%) than in subtype 1 (2%) (p = 0.042)." Conclusion: For subtype 1 fractures, the classical trochanteric entry point for PFNA is effective, whereas a more medial entry point is recommended for subtype 2 fractures to prevent loss of reduction, reduce the risk of lateral cortical fractures, and decrease the likelihood of cut-out complications.}, number={4}, publisher={İstanbul Üniversitesi}