A prospective comparative study between proximal femoral nail and dynamic hip screw treatment in trochanteric fractures of femur
Keywords:Intertrochanteric fractures, Dynamic hip screw, Proximal femoral nail, Management, Outcome
Background: Intertrochanteric (IT) fracture is one of the most common fractures of the femur in the female and elderly with osteoporotic bones, usually due to simple falls. Not many studies compared the treatment of dynamic hip screw (DHS) and proximal femoral nail (PFN), in type II intertrochanteric fractures. Hence, this study was done to compare the management, complications, functional and radiological outcome of PFN with DHS in management of type II intertrochanteric fractures.
Methods: This prospective comparative study was conducted on 60 patients of IT fractures at Santhiram General Hospital, Nandyal, Kurnool (Dist.) during the period May 2016 to September 2017. 30 cases were operated with proximal femoral nail (PFN) and 30 by using dynamic hip screw (DHS). Intraoperative details, complications and outcome of the procedures were noted, compared and analysed statistically.
Results: The mean age in DHS group was 57.5 and PFN group was 56.5 yrs. Female preponderance was observed in the study. Most of the injuries were on right side due to slip and fall in both the groups. Mean radiographic exposure (60 sec) and duration of operation (90 min) were more in PFN group compared to DHS group. Mean blood loss was 230 ml in PFN group and 320 ml in DHS group. Better anatomical and functional results were observed in PFN group compared to DHS group.
Conclusions: PFN is the better surgical procedure for elderly patients with IT fractures in terms of reduced blood loss, shorter operating time, rotational stability, good fixation, less morbidity and good outcome (anatomical and functional).
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