Proximal Compression Research Articles

Dunbar (or median arcuate ligament) syndrome: A case series

Dunbar syndrome (DS) (or median arcuate ligament [MAL] syndrome) is a rare entity of the vascular compression syndrome, where there is focal proximal coeliac axis compression by MAL. It results in an insufficient supply of blood to the respective organs of the gastrointestinal tract. Multidetector computed tomography is a very convenient, noninvasive modality in diagnosing this condition and helpful in distinguishing it from other conditions, such as atherosclerotic disease. DS can further be treated disorder surgically by relieving the compression and sometimes may need vascular reconstruction. We present five cases of the DS.

Dunbar (Or Median Arcuate Ligament) Syndrome: A Case Series

Dunbar syndrome (DS) (or Median arcuate ligament syndrome) is a rare entity of the vascular compression syndrome, where there is focal proximal coeliac axis compression by Median arcuate ligament (MAL). It results in an insufficient supply of blood to the respective organs of the gastrointestinal tract (GIT). Multi-detector computed tomography (MDCT) is a very convenient non-invasive modality in diagnosing this condition and helpful in distinguishing it from other conditions, such as atherosclerotic disease. DS can further be treated disorder surgically by relieving the compression and sometimes may need vascular reconstruction. We present five cases of the DS.

Endovasal laser obliteration of arteriovenous fistulas in patients on chronic hemodialy

Introduction. Vascular access complications are associated with about 30% of patient hospitalizations, and annual costs of vascular access maintenance account for 14–20% of total healthcare costs for dialysis patients. At the same time, current international clinical guidelines emphasize the need to implement a patient-centered approach with planning of possible vascular access complications and selection of optimal surgical interventions (risk/benefit balance) for correction of compromised access.Aim. To present the first experience of endovasal laser obliteration of arteriovenous fistulas for correction of venous hypertension syndrome.Materials and methods. The first experience of complicated arteriovenous fistulas liquidation using endovasal laser obliteration in 6 patients receiving hemodialysis replacement therapy for stage 5 chronic kidney disease (National kidney Foundation (NkF) classification) is presented. In 5 patients due to the presence of venous hypertension of the upper extremity, where the arteriovenous fistula functioned, open intervention was unacceptable because of the high risk of bleeding. In one patient the arteriovenous fistula was closed due to its aneurysmatic transformation. we performed endovasal laser obliteration of four Cimino-type radial artery-cephalic arteriovenous fistulas, one brachial-basilar arteriovenous fistula, and one brachial-cubital arteriovenous fistula. Endovasal laser obliteration was performed with an endovascular light guide under ultrasound navigation using tumescent anesthesia. we used a laser device with a wavelength of 1.56 µm and power of 15 w, working in continuous mode (time 2–4 min, energy density 500 to 1,000 J/cm). The average diameter (Me) of the fistula vein was 8 mm.Results. The course of the early postoperative period in all patients was uncomplicated. The follow-up period was 30 days. Symptoms of venous hypertension were eliminated in all patients, the pain syndrome disappeared completely, there were slight feelings of heaviness and fullness of the limb.Discussion. Experience has shown that standard modes used for varicose vein obliteration for elimination of arteriovenous fistulas in chronic renal failure are ineffective: under conditions of blood flow in the area of arteriovenous anastomosis the energy density is almost 10 times higher. Therefore, other modes were used in our study: energy density from 500 to 1,000 J/cm. This was due to the lack of coagulation of the fistula vein when using standard parameters due to high blood flow rate, despite the use of proximal and distal vascular compression. In all cases we obtained positive results (obliteration of arteriovenous fistulas) without complications along with the correction of venous hypertension within 1 month after the intervention.Conclusion. The advantages of this method are technical simplicity and minimal blood loss, which is especially important for this cohort of patients with initial anemia against chronic renal failure.

Point of care ultrasound screening for deep vein thrombosis in critically ill COVID-19 patients, an observational study

BackgroundDeep vein thrombosis (DVT) is common in critically ill patients with Coronavirus disease 2019 (COVID-19) and may cause fatal pulmonary embolism (PE) prior to diagnosis due to subtle clinical symptoms. The aim of this study was to explore the feasibility of bedside screening for DVT in critically ill COVID-19 patients performed by physicians with limited experience of venous ultrasound. We further aimed to compare inflammation, coagulation and organ dysfunction in patients with and without venous thromboembolism (VTE).MethodsThis observational study included patients with COVID-19 admitted to the intensive care unit (ICU) of a tertiary hospital in Sweden and screened for DVT with proximal compression ultrasound of the lower extremities between April and July 2020. Screening was performed by ICU residents having received a short online education and one hands-on-session. Pathological screening ultrasound was confirmed by formal ultrasound whereas patients with negative screening underwent formal ultrasound on clinical suspicion. Clinical data, laboratory findings and follow-up were extracted from medical records.ResultsOf 90 eligible patients, 56 were screened by seven ICU residents with no (n = 5) or limited (n = 2) previous experience of DVT ultrasound who performed a median of 4 (IQR 2–19) examinations. Four (7.1%) patients had pathological screening ultrasound of which three (5.6%) were confirmed by formal ultrasound. None of the 52 patients with negative screening ultrasound were diagnosed with DVT during follow-up. Six patients were diagnosed with PE of which four prior to negative screening and two following negative and positive screening respectively. Patients with VTE (n = 8) had higher median peak D-dimer (24.0 (IQR 14.2–50.5) vs. 2.8 (IQR 1.7–7.2) mg/L, p = 0.004), mean peak C-reactive protein (363 (SD 80) vs. 285 (SD 108) mg/L, p = 0.033) and median peak plasma creatinine (288 (IQR 131–328) vs. 94 (IQR 78–131) μmol/L, p = 0.009) compared to patients without VTE (n = 48). Five patients (63%) with VTE received continuous renal replacement therapy compared to six patients (13%) without VTE (p = 0.005).ConclusionICU residents with no or limited experience could detect DVT with ultrasound in critically ill COVID-19 patients following a short education. VTE was associated with kidney dysfunction and features of hyperinflammation and hypercoagulation.Trial registrationClinicalTrials ID: NCT04316884. Registered 20 March 2020.

The Fate of Proximal Junctional Vertebral Fractures after Long-Segment Spinal Fixation : Are There Predictable Radiologic Characteristics for Revision surgery?

ObjectiveTo investigate the radiographic characteristics of the uppermost instrumented vertebrae (UIV) and UIV+1 compression fractures that are predictive of revision surgery following long-segment spinal fixation. MethodsA total 27 patients who presented newly developed compression fracture at UIV, UIV+1 after long segment spinal fixation (minimum 5 vertebral bodies, lowest instrumented vertebra of L5 or distal) were reviewed retrospectively. Patients were divided into two groups according to following management : revisional surgery (group A, n=13) and conservative care (group B, n=14). Pre- and postoperative images, and images taken shortly before and after the occurrence of fracture were evaluated for radiologic characteristics ResultsDespite similar degrees of surgical correction of deformity, the fate of the two groups with proximal junctional compression fractures differed. Immediately after the fracture, the decrement of adjacent disc height in group A (32.3±7.6 mm to 23.7±8.4 mm, Δ=8.5±6.9 mm) was greater than group B (31.0±13.9 mm to 30.1±15.5 mm, Δ=0.9±2.9 mm, p=0.003). Pre-operative magnetic resonance imaging indicated that group A patients have a higher grade of disc degeneration adjacent to fractured vertebrae compared to group B (modified Pfirrmann grade, group A : 6.10±0.99, group B : 4.08±0.90, p=0.004). Binary logistic regression analysis indicated that decrement of disc height was the only associated risk factor for future revision surgery (odds ratio, 1.891; 95% confidence interval, 1.121–3.190; p=0.017). ConclusionProximal junctional vertebral compression fractures with greater early-stage decrement of adjacent disc height were associated with increased risk of future neurological deterioration and necessity of revision. The condition of adjacent disc degeneration should be considered regarding severity and revision rate of proximal junctional kyphosis/proximal junction failures.

Clinical and functional outcome of proximal humerus fractures treated with locking compression plate (LCP) in adults – A prospective study

Clinical and functional outcome of proximal humerus fractures treated with locking compression plate (LCP) in adults – A prospective study - IJOS- Print ISSN No: - 2395-1354 Online ISSN No:- 2395-1362 Article DOI No:- 10.18231/j.ijos.2020.060, Indian Journal of Orthopaedics Surgery-Indian J Orthop Surg

Role of proximal femur locking plate in management of complex proximal femoral end fractures

Introduction: To study the role of proximal trochanteric contoured plate in management of complex proximal femur end fractures. Materials and Methods: A total of 30 cases 11 male and 19 female patients aged 19 to 90 years [Mean age 42] were included. Time duration of surgery, total amount of blood loss, hospital stay, mobilization and weight bearing, radiological assessment of union, complications and Harris Hip score were assessed at the end of 6 months. Results: Mean duration of surgery was 72.18 mins, average blood loss was 283.75ml, average hospital stay was 13.75 days. Mean time for radiological union was 16.8 wks and Harris hip score was 84.6. Abductor lurch occurred in 4 cases. Conclusion: Proximal Femoral Locking Compression Plate (PFLCP) provides stable fixation for fractures of proximal end of femur especially for lateral wall fracture because it provides stable fixation of lateral fragments and prevents lateral migration of proximal fragments. Keywords: Proximal femur fractures, Proximal femur locking plate, Harris Hip Score. MESH words: Proximal femur fracture, Internal fixation, Extramedullary devices

Clinical Study on the Treatment of Posterolateral Fracture of Tibial Plateau with Modified Anterolateral Approach Proximal Tibia Locking Compression Plate

Clinical Study on the Treatment of Posterolateral Fracture of Tibial Plateau with Modified Anterolateral Approach Proximal Tibia Locking Compression Plate

Double crush syndrome: clinical review of an unsolved puzzle

<p class="abstract">Double crush syndrome (DCS) involves compression of a peripheral nerve at two different segments. Median nerve is most commonly involved with proximal compression at the level of cervical spine and distal compression in the carpal tunnel. Little consensus exists in literature regarding its epidemiology, risk factors, pathophysiology and definitive treatment. The purpose of this article is to summarize our current knowledge about this disease process as well as to touch upon the controversies that have been generated in recent times.</p>

Ulnar tunnel syndrome: pathoanatomy, clinical features and management.

Ulnar tunnel syndrome is compression of the ulnar nerve at the level of the wrist within Guyon's canal. It is most commonly caused by a ganglion cyst but may also be secondary to fractures, inflammatory conditions, neoplasm, vascular anomalies, aberrant musculature or a combination of these. Assessment should include a detailed history focusing on duration, site and progression of symptoms. The level of compression can be estimated clinically on examination by assessing motor and sensory changes in the hand. Investigations are used to confirm diagnosis or to clarify the underlying cause. X-rays and computed tomography can be used to exclude fractures. Ultrasound is used to diagnose ganglion cysts and vascular anomalies, and can localise the level of compression. Nerve conduction studies can be used to support the diagnosis and look for proximal compression. Mild symptoms can be managed non-operatively. Surgical exploration and decompression is the gold standard treatment for neuro-compressive causes with largely good outcomes.

The proximal humeral attachment of the lateral head of the triceps brachii: a cadaveric study and potential site for radial nerve compression.

Knowledge of potential compression sites of peripheral nerves is important to the clinician and surgeon alike. One anatomical location for potential compression of the radial nerve, which is rarely mentioned in the literature, is at the proximal humeral attachment of the lateral head of the triceps brachii at the level of the proximal spiral groove. As no anatomical studies have been devoted to this band, the present study was conducted. Ten adult fresh-frozen cadavers were dissected and the lateral head's attachment onto the posterior humerus evaluated for a band. This anatomy and its relation to the radial nerve during range of motion of the elbow and forearm were evaluated. A band was found on 15 of 20 arms. On five sides, the band was comprised of grossly muscle fibers of the lateral head of the triceps brachii and was not tendinous. The bands were crescent-shaped, straight, and duplicated on nine, five, and one arm, respectively. The length of the bands ranged from 1.1 to 2.2cm (mean 1.54cm). The width of the bands ranged from 0.5 to 1.1cm (mean 0.8cm). With elbow extension and the forearm in neutral, all bands were lax. With elbow extension and the forearm supinated, the bands became tauter less the muscular bands. In elbow extension and with the forearm in supination, the bands became most taut less the muscular bands. The presence of a fibrous band extending from the lateral head of the triceps brachii is common and should be among the differential diagnoses of anatomical sites for potential proximal radial nerve compression when other more common locations are ruled out.

Study of comminuted unstable intertrochanteric fractures of femur managed with proximal femoral locking plate

Aim & Objective: The main aim of the present study to investigate the comminuted unstable intertrochanteric fractures of femur managed with proximal femoral locking plate.Methodology: The present study was conducted at NRI Medical College & General Hospital, Chinnakakani, Guntur, Andhra Pradesh. During the period of April 2018 to March 2020. All the patients were selected into the study based on inclusion and exclusion criteria. The type of surgery was internal fixation of comminuted unstable intertrochanteric fractures with proximal femoral locking plate. All patients were followed up at 6weeks, 12 weeks, 6, 9, and 12 months.Results: Out of 30 patients, 20 were males and10 were females. Both anatomical and functional outcomes were assessed in these patients. Out comes were assessed with Harris hip score. The results were good to excellent in 80.01% of the cases. The majority of injured patients were males (66.66%). The average follow up period was 10 months. 60% of patients do not have any pain during follow-up. 28 of 30 fractures united within a period of 14 months. The average time of union was 14.5 weeks. Four patients had delayed union for whom delayed weight bearing was advised. 95% of fractures united within 16 weeks. The functional outcome was more that 90%.Conclusion: Proximal femoral Locking Compression Plate provides the surgeon with flexibility to achieve angular stability or axial compression with the plate to bone apposition.

CONCURRENT INSERTION AND INTERNAL FIXATION OF SELF-EXPANDABLE METALLIC STENT (SEMS) IN PROXIMAL TRACHEAL STENOSIS IN HIGH-RISK PATIENTS

TYPE: Abstract Publication TOPIC: Procedures PURPOSE: The concurrent stent insertion and fixation should be considered in patients with complex proximal tracheal lesions with a high risk of stent migration. METHODS: Case 1: Female patient 88 years old, with tracheal stenosis due to compression by mediastinal Non-Hodgins lymphoma. SEMS tracheal stent was inserted. Concurrently internal fixation was done to prevent its migration due to the presence of complex stenosis. Revelation after chemotherapy, the suture and the stent were removed. Case 2: Female Patient, 66 years old presented with proximal tracheal compression by esophageal adenocarcinoma. During the balloon dilatation after stent insertion, it was dislocated distally twice. After stent pulling up, the internal suturing of the stent was performed. RESULTS: No results (case report). CONCLUSIONS: The concurrent stent insertion and fixation were associated with satisfying clinical and bronchoscopic results. It should be considered in selected patients with complex tracheal lesions and high risk of stent migration. When indicated, both suture and stent could be easily removed. CLINICAL IMPLICATIONS: We performed an internal fixation of SEMS using a simple intratracheal suture to fix the proximal end of the stent to the posterior wall of the trachea. The thinner wall of SEMS and lower force needed to penetrate the fenestrated metal stent with the suture needle is easier in comparison to the silicon one. The prophylactic fixation aimed to avoid stent migration either due to high risk of migration or observed instability of the stent. The internal fixation overcomes the drawbacks of the external fixation including puncture of neck and trachea, skin maceration, and swallowing discomfort. DISCLOSURE: No significant relationships. KEYWORDS: stent migration, internal fixation, Tracheal stenosis

Motor Recovery of the Suprascapular Nerve after Arthroscopic Decompression in the Scapular Notch – a Systematic Review

The suprascapular nerve can be compromised as a result of a compression syndrome in different locations. A (proximal) compression within the scapular notch can lead to dorsal shoulder pain and simultaneous weakness of the infraspinatus and supraspinatus muscles. By transection of the lig. transversum this compression syndrome can be treated. By means of a systematic review, the present work analyzes the motor recovery potential after arthroscopic decompression. A systematic review of the U. S. National Library of Medicine/National Institutes of Health (PubMed) database and the Cochrane Library was performed using the PRISMA checklist. The search words used were "suprascapular" and "arthroscopic"; "suprascapular" and "arthroscopy". Based on the evaluated literature, articles in English with at least a partial arthroscopic case series from 4 cases on and a compression syndrome of the suprascapular nerve treated with arthroscopic decompression in the scapular notch were identified. Motor recovery was described by means of EMG, clinical strength and MRI. Primarily 408 hits were generated. Six articles met the inclusion criteria and were further analyzed. The number of arthroscopic cases was between 4 and a maximum of 27. The level of evidence was between III and IV. The majority of the reported clinical results were good. Motor recovery as measured by EMG was observed, recovery of full strength was not achieved in the majority of reported cases (60%), neither was regression of structural (fatty) degeneration of the muscle bellies. Arthroscopic decompression of the suprascapular nerve in the scapular notch provides good clinical results and considerable pain relief. However, in the majority of cases it does not lead to a complete recovery of the strength of the supra- and infraspinatus muscles. Patients should be informed about this. An early decompression after diagnosis in the event of proximal compression within the suprascapular notch combined with beginning EMG or MRI changes appears reasonable. These beginning changes should be further defined. Future studies should develop prognostic criteria for motor recovery. Awareness regarding the diagnosis needs to be improved due to the probably time-dependent irreversibility of resulting muscular weakness.

Biomechanical Effects of Tibial Plateau Levelling Osteotomy on Joint Instability in Normal Canine Stifles: An In Vitro Study.

The aim of the study was to determine the changes in biomechanical characteristics following tibial plateau levelling osteotomy (TPLO) using simulated manual tests. Twenty-one stifles from healthy Beagle dogs that had undergone TPLO or had not (control) were first tested in the intact form, and then the cranial cruciate ligament (CrCL) was transected in each to provide four test situations: control-intact, control-CrCL-transected, TPLO-intact and TPLO-CrCL-transected. The stifles were then analysed using a robotic joint biomechanical testing system. The craniocaudal drawer, axial rotation and proximal compression tests were applied. The craniocaudal displacement during the drawer test was not significantly different between the control-intact and TPLO-intact. However, the displacement was significantly greater in the TPLO-CrCL-transected than in the control-intact. In the axial rotation test, the internal-external (IE) rotation was significantly greater in the TPLO-intact than in the control-intact. Similarly, the IE rotation was significantly greater in the TPLO-CrCL-transected than in the control-CrCL-transected. In the proximal compression test, craniocaudal displacement was not significantly different among the control-intact, TPLO-intact and TPLO-CrCL-transected. These findings suggest that TPLO influences the tension of the collateral ligaments and might generate laxity of the tibiofemoral joint. Instability after the osteotomy might be associated with the progression of osteoarthritis.

Temporizing Life-Threatening Abdominal-Pelvic Hemorrhage Using Proprietary Devices, Manual Pressure, or a Single Knee: An Integrative Review of Proximal External Aortic Compression and Even "Knee BOA".

Abdominal-pelvic hemorrhage (i.e., originates below the diaphragm and above the inguinal ligaments) is a major cause of death. It has diverse etiology but is typically associated with gunshot or stab wounds, high force or velocity blunt trauma, aortic rupture, and peripartum bleeds. Because there are few immediately deployable, temporizing measures, and the standard approaches such as direct pressure, hemostatics, and tourniquets are less reliable than they are with compressible extremity injuries, risk for death resulting from abdominal-pelvic hemorrhage is high. This review concerns the exciting potential of proximal external aortic compression (PEAC) as a temporizing technique for life-threatening lower abdominal-pelvic hemorrhage. PEAC can be accomplished by means of a device, two locked arms (manual), or a single knee (genicular) to press over the midline supra-umbilical abdomen. The goal is to compress the descending aorta and slow or halt downstream hemorrhage while not delaying more definitive measures such as hemostatic packing, tourniquets, endovascular balloons, and ultimately operative repair. Clinical review of the Ovid MEDLINE, In-Process, & Other Non-Indexed, and Google Scholar databases was performed for the period ranging from 1946 to 3 May 2019 for studies that included the following search terms: [proximal] external aortic compression OR vena cava compression AND (abdomen or pelvis) OR (hemorrhage) OR (emergency or trauma). In addition, references from included studies were assessed. Sixteen studies met the inclusion criteria. Evidence was grouped and summarized from the specialties of trauma, aortic surgery, and obstetrics to help prehospital responders and guide much-needed additional research, with the goal of decreasing the high risk for death after life-threatening abdominal-pelvic hemorrhage.

Results of Operative Treatment of Peritrochanteric Osteoporotic Fractures with Proximal Femur Locking Compression Plate. A consecutive study

Results of Operative Treatment of Peritrochanteric Osteoporotic Fractures with Proximal Femur Locking Compression Plate. A consecutive study

Current Status of Nerve Transfers: “Supercharge End-to-Side Transfer in Severe Cubital Syndrome”

Supercharge end-to-side (SETS) technique has been increasingly implemented in the treatment of nerve pathologies. It was known for its use in ulnar injury, and although it seemed that its usefulness was more directed to injuries due to ulnar nerve section, with this work and based on all the literature available to date, the aim is to assess the possibilities of implementation based on the results of the articles published in compression-type injuries, especially those classified as severe that have little treatment available to improve their evolutionary course, and where their use to date was doubtful. A compilation is made of all the evidence to date of cubital tunnel syndrome, focused on treatments, and on the emergence of the SETS technique as a therapeutic option. The purpose of the study was to collect and review the indications, results, and complications of end-to-side axonal super feeding transfer of the interosseous nerve anterior to the ulnar nerve. Twenty-one articles that met the inclusion and exclusion criteria were finally reviewed, most of them retrospective (level of evidence IV) and some review or case series (level of evidence II/ III). The data has been pooled and analyzed focusing on the primary outcomes: intrinsic muscle recovery and complications. SETS is a successful procedure with low morbidity, which can restore the function of the intrinsic musculature in patients with severe proximal ulnar nerve compression injuries thanks to the anterior interosseous nerve (median branch) that serves as a donor. Although the technique has already begun to be introduced in the sketch of the treatment of the lesion, to implement it with assured success, prospective studies should be carried out that corroborate it with greater certainty than the articles published on the subject to date. Even so, it has been possible to verify as previous indications for performing supercharge: a normal donor nerve electromyogram (it will be performed in a pronator square), a preoperative electromyogram of the injured nerve that must have a reduced amplitude of compound muscle action potential (demonstrating axonal loss) and an electromyogram to know if the denervated motor endplates remain receptive to reinnervation (check they have spontaneous activity and this is shown by fibrillation potentials and / or acute positive waves).

Management of Seinsheimer type IIB and type IIIA subtrochanteric fracture with proximal femoral nail (PFN) versus proximal femoral locking compression plate (PF-LCP): Prospective comparative study

Introduction: Seinsheimer subtrochanteric fracture of femur are important to treat and associated with high rate of complications. Among all fractures of hip upto 34% present in subtrochanteric area. Objectives: Comparison of clinical outcome in Seinsheimer type IIB and type IIIA subtrochanteric fractures treated with proximal femoral nail (PFN) versus proximal femoral locking compression plate (PF-LCP). Materials and Methods: Patients presented with Seinsheimer subtrochanteric fracture at our hospital i.e, R L Jalappa Hospital, Tamaka, Kolar, Karnataka, India between May 2018 to June 2019 among which fourty patients were included as per the inclusion criteria. In which twenty patients were treated with Proximal Femoral Nail and twenty patients with Proximal Femoral Locking Compression Plate. By using Modified Harris Hip Score results were assessed at final follow up. Results: Group PFN shows at final follow up 45% excellent outcome, 45% good outcome and 10% fair outcome whereas group PF-LCP shows 60% good outcome, 20% fair outcome and 20% poor. Conclusion: For Seinsheimer subtrochanteric fractures proximal femoral nail shows better results compared to plating group with respect to functional outcome and clinical outcome. Keywords: Subtrochanteric fracture, Seinsheimer, PFN, PF-LCP.

Comparing the outcomes of intertrochanteric fractures treated with DHS vs PFLCP

Background: For trochanteric fractures many implants have been used successfully like sliding hip screws, cephalomedullary nails, angular blade plates, and rarely by primary hip arthroplasty. The Dynamic Hip Screw (DHS) is one of the most widely used implant for stabilization of intertrochanteric fractures. The Proximal Femoral Locking Compression Plate (PFLCP) is a relatively newly introduced implant for trochanter fractures, and there is no sufficient literature comparing DHS and PFLCP. Objective: (1) Compare the operative differences, radiological and clinical outcomes between the trochanter fractures treated by DHS with those treated by PFLCP. Methods: We studied 52 patients admitted and followed up at MGMCH. Out of which 26 patients were treated with DHS, and 26 patients with PFLCP. Results: The mean operative time and average intra-operative blood loss was more in the PFLCP group when compared with DHS group and it was found to be statistically significant (p< 0.05). DHS group had marginally better functional results than PFLCP group. There was no difference in the radiological outcome between two groups. Conclusions: In trochanteric fractures of femur, both PFLCP and DHS provide excellent results. Functional outcome is more influenced by quality of fracture reduction, rather than the type of implant used.