Treatment of Unstable Intertrochanteric Femoral Fractures by Dynamic Hip Screw Vs Proximal Femoral Nailing

Abstract

Background : Inter trochanteric fractures are increasing as the incidence of contributing conditions like osteoporosis, old age and trauma increases. Unstable fractures pose a challenge in management of these fractures. Multiple options for fixation are available but the more commonly used DHS has its own pros and cons. Intra medullary devices offer more stable construct and a good functional outcome. Method : A prospective study was done on 40 cases of unstable intertrochanteric fractures. They were randomly allocated to two groups. Group A was treated with DHS and group B with PFN. Post operatively the cases were followed up for a period of 2 years at regular intervals. Comparison between the two groups in terms of intra operative and post-operative advantages was done . Results : Intra operative parameters like operative time and blood loss were more in DHS group whereas radiation exposure was more in PFN group. Post-operative parameters like duration of stay in hospital, early weight bearing, union rate, infection rate, implant failure was favourable in PFN group. Conclusion : In treatment of Unstable Intertrochanteric Fractures PFN is better than DHS.