Comparative evaluation of management of intertrochanteric fracture femur with proximal femoral nailing versus dynamic hip screw

Authors

  • Navneet Adhikari Department of Orthopaedics, Government medical college Halwani, Nainital, Uttarakhand, India
  • Chandra Shekhar Department of Orthopaedics, Government medical college Halwani, Nainital, Uttarakhand, India
  • Ganesh Singh Department of Orthopaedics, Government medical college Halwani, Nainital, Uttarakhand, India
  • Hardev Singh Department of Orthopaedics, Government medical college Halwani, Nainital, Uttarakhand, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20203730

Keywords:

DHS, PFN, Intertrochanteric fracture, Harris hip score

Abstract

Background: Fractures involving trochanteric region of femur are one of the common fractures affecting elderly population. Presently surgical treatment is the treatment of choice with early mobilisation as primary goal. The two most common implants that are used are Dynamic hip screw (DHS) and Proximal femoral nail (PFN).

Methods: This was a prospective study with 50 patients divided randomly into two groups of 25 each. One group operated by PFN and other with DHS. Patients were evaluated periodically and final comparison between two group was done at six months for analysing results on the basis of Harris hip score.

Results: At final follow up in patients in PFN group 9 (36%), 7 (28%), 5 (20%), 4 (16%) patients had functional grade in excellent, good, fair and poor category respectively. In DHS group patients, 7 (28%), 10 (40%), 6 (24%), 2 (8%) patients had functional grade in excellent, good, fair and poor functional grade. Harris hip score was insignificantly (p>0.05) lower in patients of PFN (82.68±12.28) than DHS (84.60±10.39).

Conclusion: At final follow up we found that pain, limp, use of support while walking and hospital stay was less in PFN group. However, range of motion and hip functions were better in patients treated with DHS. Complications like Varus malunion and infection were common in DHS group while hip joint stiffness was seen more commonly in PFN group. So, both PFN and DHS in are comparable in respect to most of functional criteria for treatment of intertrochanteric fracture femur.

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Author Biographies

Navneet Adhikari, Department of Orthopaedics, Government medical college Halwani, Nainital, Uttarakhand, India

ORTHOPEDICS, SENIOR RESIDENT DOCTOR

Chandra Shekhar, Department of Orthopaedics, Government medical college Halwani, Nainital, Uttarakhand, India

Orthopaedics, Assistant Proffesor

Ganesh Singh, Department of Orthopaedics, Government medical college Halwani, Nainital, Uttarakhand, India

ORTHOPAEDICS, ASSOCIATE PROFFESOR

Hardev Singh, Department of Orthopaedics, Government medical college Halwani, Nainital, Uttarakhand, India

ORTHOPAEDICS, CONSULTANT

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Published

2020-08-26

How to Cite

Adhikari, N., Shekhar, C., Singh, G., & Singh, H. (2020). Comparative evaluation of management of intertrochanteric fracture femur with proximal femoral nailing versus dynamic hip screw. International Journal of Research in Orthopaedics, 6(5), 1050–1056. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20203730

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Section

Original Research Articles