A comparison study of proximal femoral nail and dynamic hip screw devices in unstable trochanteric fractures

Abstract

Background Trochanteric fracture of the femur is a common orthopedic injury in the geriatric population, and the use of extramedullary dynamic hip screw (DHS) is still more superior with fewer complication rates in stable trochanteric fractures. On the contrary, proximal femoral nail (PFN) may have some advantages in fractures at the level of lesser trochanter, reversed obliquity fractures and in subtrochanteric fracture, although the evidence is yet insufficient. Aim The aim of this study was to compare the results of treatment of unstable trochanteric fracture of femur in 40 patients treated by either PFN or DHS regarding primary outcomes: early mobilization, pain improvement, radiological assessment for fracture reduction and fixation and secondary outcome. Patients and methods This study was conducted on 40 patients with unstable pertrochanteric fractures treated surgically, where 20 patients were treated by DHS and 20 patients were treated by PFN. All were planned for follow-up examination for a period of 8 months from the date of operation. Full workup including the age, sex, medical history, type of fracture, mechanism of injury, and plain radiographs was carried out on admission. Results In this study, the duration of union in the whole study population ranged from 1.5 to 8 months, whereas in the group of patients with trochanteric fractures, it ranged from 2 to 8 months. Conclusion We recommend to conduct larger studies to further evaluate the DHS and PFN in the management of unstable trochanteric fractures, with a longer follow-up duration.