Proximal Femoral Nail Antirotation (PFNA) Versus PFNA Augmentation

• Mobility measured with the "timed up & go"-test during hospital stay. [ Time Frame: 5 to 7 days postoperative ] [ Designated as safety issue: No ]
  The TUG measures the time (in seconds) that it takes for an individual to rise from an armchair (chair seat height = 45 cm / 1.5 feet), walk 3 meters (= 10 feet) to a line drawn on the floor, turn around and return to the chair. The time is measured from a seated position (back against the backrest) with a stopwatch started on the command "ready - go" and stopped when the seat position is reached again. Patient-perceived pain and exertion will be assessed after the test.
  
  

• Description of surgical details as surgery time and fluoroscopy time, and of augmentation details (PFNA Augmentation group only). [ Time Frame: Intraoperative ] [ Designated as safety issue: No ]
  
• Pain [ Time Frame: one year ] [ Designated as safety issue: No ]
  Pain, measured with the Numerical Rating Scale (NRS) and use of pain medication postoperative.
  
  
• Duration of hospital stay [ Time Frame: one year ] [ Designated as safety issue: No ]
  
• Walking ability [ Time Frame: one year ] [ Designated as safety issue: No ]
  Parker Mobility Score
  
  
• Return to pre-fracture residential status [ Time Frame: one year ] [ Designated as safety issue: No ]
  
• Timed up & go-test at follow-ups [ Time Frame: one year ] [ Designated as safety issue: No ]
  The TUG measures the time (in seconds) that it takes for an individual to rise from an armchair (chair seat height = 45 cm / 1.5 feet), walk 3 meters (= 10 feet) to a line drawn on the floor, turn around and return to the chair. The time is measured from a seated position (back against the backrest) with a stopwatch started on the command "ready - go" and stopped when the seat position is reached again.
  
  
• Quality of life [ Time Frame: one year ] [ Designated as safety issue: No ]
  EuroQol-5D
  
  
• Local adverse events and revision rate [ Time Frame: one year ] [ Designated as safety issue: No ]
  Implant / surgery, bone / fracture, soft tissue of the musculoskeletal system, wound related adverse events
  
  
• Systemic adverse events [ Time Frame: one year ] [ Designated as safety issue: No ]
  
• Implant migration [ Time Frame: one year ] [ Designated as safety issue: No ]
  Measured at the CT in a subgroup only
  
  
• Mortality [ Time Frame: one year ] [ Designated as safety issue: No ]
  
• Fracture risk prior to injury [ Time Frame: 1 week prior to operation ] [ Designated as safety issue: No ]
  Measured with the Fracture Risk Assessment Tool (FRAX)
  
  
• Functional independence [ Time Frame: 1 week prior to operation ] [ Designated as safety issue: No ]
  Measured with the Barthel Index
  
  
• Comorbidity [ Time Frame: 1 week prior to operation ] [ Designated as safety issue: No ]
  Charlson Comorbidiy Index
  
  

To avoid the pain-causing relative movement between implant and bone, surgical techniques and devices allowing augmentation of the femoral head have recently been developed. Biomechanical studies showed that augmentation leads to a better axial stability and pull-out strength. In clinical practice, this might facilitate early mobilization and full weight-bearing with less pain. The purpose of this study is therefore to evaluate whether patients with trochanteric fractures being treated with a PFNA and augmentation can better be mobilized than patients without augmentation. In particular, it will be measured whether patients with a PFNA Augmentation can walk faster than the non-augmented patients, measured with the Timed up and Go test.