DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20180680

Treatment of trochanteric fractures by PFN or DHS

B. S. Sahoo, Dillip Kumar Chand

Abstract


Background: Intertrochanteric fracture is one of the common fractures of the hip in the elderly over the age of 50 years. Dynamic hip screw is still considered the gold standard for treating intertrochantric fractures by many. Not many studies compare the DHS with proximal femoral nail (PFN).

Methods: This prospective study included 32 patients of intertrochanteric fractures in which 16 patients were treated by PFN and rest 16 by DHS. All patients were operated under image intensifier control. Average age of the patients was 65 years (20-80) years.

Results: In our series the patients with DHS has increased intra operative blood loss (160 ml), longer duration of surgery (54.6 min) and required longer time for mobilization (15 weeks) while patients who underwent PFN had lower intra op blood loss (95 ml), shorter duration of surgery (41.2 min). The Salvati and Wilson hip scoring is better in PFN group.

Conclusions: PFN produces better results than DHS in terms of shorter duration of surgery, early weight bearing, lower infection rate and less blood loss.


Keywords


Dynamic hip screw, Intertrochanteric fractures, Proximal femoral nail, Salvati and Wilson hip score

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References


Dimon JH, Hughston JC. Unstable intertrochanteric fractures of the hip. J Bone Surg Am.1967;49(3):440-50

Boyd HB,GRIFFIN classification and treatment of trochanteric fractures Arch surgery, 1949;58;853-866

David GL. Fractures and dislocation of hip. Campbells operative orthopaedics.11th ed., ch.52, Vol.3. Philadelphia, Pennsylvania, USA: Mosby Elsevier; 2010.p.3237-308.

Klinger HM,Baums MH,Eckert M,Neugebauer R.Acomparative study of unstable per and intertrochanteric femoral fractures treated with dynamic hip screw and trochanteric buttress plate vs proximal femoral nail.Zentralbl chir 2005;130:301-6

Xu YZ,Geng DC,Mao HQ,Zhu XS,Yang HL. Acomparision of the proximal femoral nail antirotation device and dynamic hip screw in the treatment of unstable pertrochanteric fracture.J Int Med Res2010; 38: 1266-75

Baumagaertner MR, Chrostowski JH,Levy RN,Bronwer BD,Levine AM,Jupiter JB,etal.Intertrochanteric hip fracture In:editors,Skeletal trauma,Vol.2.Philadelphia:WBsaunders;1992.p.1833-81.

Taeger G.Schmid C, Zettl R, Schweiberer L, Nast-kolb D, stable and unstable pertrochanteric femoral fractures. Differentiated indications for the dynamic hip screw Unfallchirurg 2000;103:741-8