A prospective, comparative study between the use of the proximal femoral nail and trochanteric support plate for management of pertrochanteric hip fracture

Abstract

Introduction: The proximal femoral nail (PFN) and dynamic hip screw with trochanteric support plate are two implants used in the management of pertrochanteric hip fracture. In this study, we try to find out if one implant is better than the other. Materials and Methods: A total of 40 patients were included with 20 each in both the groups between August 2016 and February 2018 in this prospective observational study. All patients were recorded and analyzed for the length of incision (LoI), period of hospitalization (PoH), blood loss, time of union (ToU), duration of surgery (DoS), Parker and Palmer mobility score (PPMS), and Harris hip score (HHS). Results: PFN was found to have a statistical advantage over TFN in terms of LoI (6.4 vs. 14.7 cm.), DoS (70.65 vs. 105.25 min), blood loss (97.25 vs. 294.0 ml), ToU (14.9 vs. 17 days), and PoH (18.1 vs. 21.6 days). While PPMS (7.05 vs. 6.5) was comparable in both groups, HHS (90.25 vs. 81.6) was better in the PFN group. Conclusions: PFN was found to be a better minimally invasive implant for pertrochanteric fractures when closed reduction is possible in terms of LoI, PoH, ToU, DoS, blood loss, and HHS but not for PPMS.