Long term functional outcome of intertrochanteric femur fractures treated with dynamic hip screw v/s proximal femoral nail: Retrospective study

Abstract

Background: Trochanteric fractures are devastating injuries that most commonly affect the elderly and also in young, have a tremendous impact on both the health care system and society in general. The mainstay of treatment of intertrochanteric fracture is fixation with a screw slide plate device or intramedullary device. The purpose of this retrospective study to review the long term functional outcome of Intertrochanteric femoral fractures treated with dynamic hip screw (DHS) v/s proximal femoral nail (PFN). Methods: This study was conducted on 1000 patients of both sexes with intertrochanteric femoral fractures above 16 years of age group which were operated for intertrochanteric femoral fracture by DHS (500patients) and PFN (500patients) from January 2009 to December 2012. Functional results were assessed by Harris hip scoring system. Results: In our study Mean age-62.66±16.99. The ratio of males to female was 1.23:1. 85.2% of patients were found with domestic fall and both sides were equally involved. In our study 5.2% cases of infection notated in the PFN group and 9.4% in the D.H.S group. Peri-Implant fracture occurred in 8 cases (1.6%) in PFN group and 19 cases (3.8%) in DHS group. Mechanical complications like (Breakage of PFN/ DHS screw and PFN/ DHS plate) occurred in 24 cases (4.8%) in PFN group and in DHS group were found in 16 cases (3.2%). Deformity (varus deformity and external rotation) occurred in 11 cases (2.2%) in PFN group and 44 cases (8.8%) in DHS group. Mean HHS of PFN was 92.064 and of DHS was 91.753(p=0.425). Conclusions: We conclude that long term functional outcome measured by HHS of Intertrochanteric femoral fractures treated with dynamic hip screw v/s proximal femoral nail have no significant difference but complication like peri-implant fracture, Shortening, Screw cut-out, varus deformity were more in patient operated by DHS.