Comparative study between dynamic hip screw and plate with proximal femoral nailing in trochanteric fractures of femur


  • M. K. Nizamoddin Khateeb Department Of Orthopaedics, ESIC Medical College, Kalaburagi, Karnataka, India
  • Satish Babu D. G. Department Of Orthopaedics, ESIC Medical College, Kalaburagi, Karnataka, India



Inter-trochanteric fractures, Dynamic hip screw, Proximal femoral nail


Background: Incidence of intertrochanteric fractures has increased significantly during recent years and it will probably continue to rise in near future due to increased longevity of life. Closed methods of treatment for intertrochanteric fractures have increased mortality rates & have largely been abandoned. Rigid internal fixation and early mobilization has been the standard protocol of treatment nowadays. This study was intended to compare the results of Intertrochanteric fractures treated by dynamic hip screw (DHS) over proximal femoral nailing (PFN).

Methods: This is a randomized prospective study of 102 cases of intertrochanteric fractures, admitted to Mysore Medical College & Hospital, Mysore and ESIC medical college and hospital Kalaburagi and Kamareddy Ortho & Trauma care Hospital Kalaburagi; treated with proximal femoral nailing and DHS. The patients were divided randomly into two groups, each of 51 patients, 51 were treated by Dynamic Hip Screw & 51 were treated with proximal femoral nail (PFN).All patients were followed up for one year.

Results: In our series of 102 patients of Intertrochanteric fractures, 51 were treated with sliding hip screw with plate and 51 were treated by an intra-medullary hip screw. Most of the patients were between 51 to 80 years. Slip and trivial fall accounted for 70% cases. Right side was more common accounted for 58.34% of cases.

Conclusions: From our study, we consider PFN as better alternative to DHS in more unstable fractures with technically difficulty and require more experience. Sliding hip screw remains the implant of choice for stable type fractures. We noticed less operative time, less blood loss, fewer intra-op complications in PFN group. The quality of the reduction achieved & proper positioning of the implant are important to achieve the best post-operative outcome.

Author Biography

M. K. Nizamoddin Khateeb, Department Of Orthopaedics, ESIC Medical College, Kalaburagi, Karnataka, India

Assistant professor

Department of ORTHOPAEDICS


Robert W, Heckman JD, Court-Brown CM. Rockwood and Green’s Fractures in Adults, 2014: 1827-1844.

Lavelle DG. Fractures and dislocations of the hip. In: Cambell’s Operative Orthopaedics. Chapter 52. Volume 3. 11th edition. 2016: 3237-3308.

Kenneth KJ, Joseph ZD. Hip fractures-A practical guide to management page. 191-252

Carter D, Hayes W. The Compressive Behavior of Bone as a Two-Phase Porous Structure. J Bone Joint Surg. 1977;59(7):954- 62.

Kish B, Sapir O, Carmel A, Regev A, Masrawa S. Full weight bearing after unstable per and subtrochanteric fracture using proximal femur nail. J Bone Joint Surg (Br). 2001;83:289.

Parker MJ, Handoll HH. Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extracapsular hip fractures in adults. Cochrane Database Syst Rev. 2008;(3):CD000093.

Steinberg EL, Blumberg N, Dekel S. The fixation proximal femur nailing system: biomechanical properties of the nail and a cadaveric study. J Biomech. 2005;38(1):63-8.

Hardy DC, Descamps PY, Krallis P, Fabeck L, Smets P, Bertens CL, et al. Use of an Intramedullary Hip Screw Compared with a Compression Hip Screw with a Plate for Intertrochanteric Femoral Fractures. A Prospective Randomized Study of One Hundred Patients. J Bone Joint Surg Am. 1998;80(5):618-30.

Spivak JM, Zuckerman JD, Kummer FJ, Frankel VH. Fatigue Failure of Sliding Hip Screw in Hip Fractures. A Report of Three Cases. J Orthop Trauma. 1991;5(3):325-31.

Guyer P, Landolt M, Keller H, Eberle C. Gamma Nails and Dynamic Hip Screws for Pertrochanteric Fractures. A Randomized Prospective Study in Elderly Patients. Aktuelle Traumatol. 1991;21(6):242-9.

Kulkarni GS, Limaye R, Kulkarni M, Kulkarni S. Current Concept review Intertrochanteric fractures. Indian J Orthop. 2006;40(1):16-23.

Boldin C, Seibert FJ, Fankhauser F, Peicha G, Grechenig W, Szyszkowitz R. Proximal femoral nail (PFN) –A minimal invasive treatment of unstable proximal femoral fracture. Acta Orthop Scand. 2003;74(1):53-8.






Original Research Articles