Proximal femoral nail v/s Dynamic hip screw in treatment of intertrochanteric fracture femur

Abstract

Objectives: Comparison of operative management and functional outcome of femoral intertrochanteric fractures by dynamic hip screw v/s proximal femoral nail implants. Materials and Methods: During 2013 to 2016, 50 patients with intertrochanteric femur fracture were prospectively studied. Fractures included were AO type 31 A1 & A2. 25 patients each were taken in two groups DHS & PFN. These groups were compared for functional outcomes based on parameters: Harris hip score, operative time, radiation exposure, blood loss and postoperative rate of union. Results: The age group in both groups was comparable with mean of 72.9 years. Domestic fall was found to be the most common cause of intertrochanteric fracture femur. Among the patients, 12 had A1 type fracture while 38 of them had A2 type fracture. PFN had the mean blood loss of 111.8ml as compared to 325.6 ml in DHS group. Radiation exposure was greater in PFN than DHS surgery. PFN had the mean operating time of 116.4 min and DHS had 106.4 min. Among the DHS treated group one case had superficial infection while two cases went into non union. Of the PFN treated group Z effect was observed in one case. Although the PFN treated patients showed a better Harris Hip Score on the initial 3 month follow up, both the implants DHS & PFN had a similar functional outcome on long term follow up. Conclusion: Any patient with intertrochanteric femur fracture AO type 31A1 & A2 treated with good surgical skill and reduction of fracture was achieved has similar results with DHS or PFN. Keywords: Intertrochanteric fracture, Dynamic hip screw, Proximal femoral nail.