Comparison of functional outcomes of pertrochanteric fractures of the femur managed with dynamic hip screw with a locking side plate versus proximal femoral nail
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20231181Keywords:
PFN, Stable, Locking DHS, Pertrochanteric, OutcomesAbstract
Background: In current practice, proximal femoral nail (PFN) and dynamic hip screw (DHS) with locking side plate are the implant of choice in stable trochanteric fractures. Most of the deficiencies of the standard DHS have been addressed by the introduction of the Locking side plate. There are plenty of studies comparing standard DHS and PFN. But studies comparing locking DHS and PFN are scarce in current literature. This study aimed to compare the outcomes of both implants in stable pertrochanteric fractures.
Methods: The objective of this study was to assess and compare the clinical outcomes of using locking DHS and PFN for fixation in 40 patients who were admitted to SUT Academy of Medical Sciences between October 2017 and April 2019. The modified Harris hip score was used to evaluate the patients' progress, and regular follow-up was conducted to compare their outcomes.
Results: Among the DHS group, the mean Harris hip score was 83.05, with excellent results observed in 2 patients (10%), good results in 12 patients (60%), fair results in 5 patients (25%), and poor results in 1 patient (5%). In comparison, the PFN group had a mean Harris hip score of 85.50, with excellent results seen in 6 patients (30%), good results in 10 patients (50%), fair results in 3 patients (5%), and poor results in 1 patient (5%).
Conclusions: The DHS group had more patients with good and fair outcomes, while the PFN group had more patients with excellent and good outcomes. Based on these findings, we can conclude that both the PFN and DHS with locking side plate are similarly effective in treating stable intertrochanteric fractures.
References
LeBoff M, Greenspan S, Insogna K, Lewiecki EM, Saag KG, Singer AJ, et al. The clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int. 2022;33(10):2049-102.
Carpintero P, Caeiro JR, Carpintero R, Morales A, Silva S, Mesa M. Complications of hip fractures: A review. World J Orthop. 2014;5(4):402-11.
Iyengar K, Vaish A, Vaishya R. Revisiting conservative orthopaedic management of fractures during COVID-19 pandemic. J Clin Orthop Trauma. 2020;11(4):718-20.
Agrawal P, Gaba S, Das S, Singh R, Kumar A, Yadav G. Dynamic hip screw versus proximal femur locking compression plate in intertrochanteric femur fractures (AO 31A1 and 31A2): A prospective randomized study. J Nat Sci Biol Med. 2017;8(1):87-93.
Ozkan K, Türkmen I, Sahin A, Yildiz Y, Erturk S, Soylemez MS. A biomechanical comparison of proximal femoral nails and locking proximal anatomic femoral plates in femoral fracture fixation. Indian J Orthop. 2015;49(3):347-51.
Dylan PAJ, Gheduzzi S, Mitchell MS, Miles AW. Locking plates increase the strength of dynamic hip screws. Injury. 2008;39(2):209-12.
Bakshi AS, Kumar P, Brar BS. Comparative study between DHS and PFN in intertrochanteric fractures of femur. Int J Orthopaed Sci. 2018;4(1):259-62.
Qidwai SA, Singh R, Mishra AN, Trivedi V, Khan AA, Kushwaha SS, et al. Comparative study of functional outcome of the intertrochanteric fracture of femur managed by dynamic hip screw and proximal femoral nail. Natnl J Clin Orthopaed. 2019;3(1):26-30.
Sharma A, Sethi A, Sharmaa S. Treatment of stable intertrochanteric fractures of the femur with proximal femoral nail versus dynamic hip screw: a comparative study. Rev Bras Ortop. 2018;53(4):477-81.
Parikh KN, Parmar C, Patel M, Shah SB. Functional and radiological outcome of proximal femoral nailing versus dynamic hip screw in unstable intertrochanteric femur fractures. Int J Res Orthop. 2018;4(6):861-6.
Harish K, Paleti ST, Kumar RN. A comparative study between DHS and PFN for the treatment of IT fractures. Natnl J Clin Orthopaed. 2019;3(3):1-7.
Gill SPS, Mittal A, Raj M, Singh P, Kumar S, Kumar D. Dynamic hip screw with locked plate vs proximal femoral nail for the management of intertrochanteric fracture: a comparative study. Int J Orthopaed Sci. 2017;3(2):173-80.
