A study to assess proximal femoral nailing versus dynamic hip screw device in surgical management of intertrochanteric fractures: a comparative study
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20184719Keywords:
Fracture, Distal, Femoral, Hip, ImplantAbstract
Background: The incidence of inter trochanteric fracture is expected to have doubled by 2040. Inter trochanteric fractures account for about 45% to 50% of all hip fractures in the elderly populationand out of these, near about 50% to 60% are classified as unstable intertrochanteric fractures. The goal of treatment is restoring mobility safely and efficiently, while minimizing the risk of medical complications and technical failure. This study as performed to assess functional outcome with dynamic hip screw and proximal femoral nail in intertrochanteric fracture management.
Methods: It was prospective observational study done for a period of 1year from January 2016-January 2017 among patients who attended OPD or emergency department with intertrochanteric fracture. Two different implants were used dynamic hip screw (DHS) and proximal femoral nail (PFN).
Results: Excellent results in functional outcome was more in case of PFN (66.6%) compared to DHS (50%). The type of trauma in DHS group was road traffic accident in 38.8%, domestic fall in 50% and others such as assault was in 11.1% while in PFN group intertrochanteric fracture was seen in 61.1% due to domestic fall.
Conclusions: The functional outcome was more better with proximal femoral nail (PFN) compared to dynamic hip screw (DHS). Therefore, proximal femoral nail (PFN) should be preferred for management of intertrochanteric fractures.
References
Hwang LC, Lo WH, Chen WM. lntertrochanteric fractures in adults younger than 40 years of age. Arch Ortho Trauma Surg. 2001;121(3):123-6.
Zuckerman JD. Hip fracture. New Eng J Med. 1996;334(2):1519-23.
Dieter M, Lindskog MD, Michael R, Baumgaertner MR. Unstable IT hip fractures in the elderly. J Am Acad of Ortho Surg. 2004;12(3):179-90.
Babhulkar SS. Management of trochanteric fractures. Indian J Orthop. 2006;40:210-8.
Jensen JS. Trochanteric fractures. An epidemiological, clinical and biomechanical study. Acta Orthop Scand. 1981;188:1-100.
Canale TS. Campbell’s operative orthop, 9th Ed. 1998: 218.
Mansukhani SA, Tuteja SV, Kasodeka VB, Mukh SR. A Comparative study of the Dynamic Hip Screw, the Cemented Bipolar Hemiarthroplasty and the Proximal Femoral Nail for the Treatment of Unstable Intertrochanteric Fractures. J Clin and Diag Res. 2017;11(4):14-9.
Bridle SH, Patel AD, Bircher M, Calvert PT., “Fixation of intertrochanteric fractures of the femur. A randomized prospective comparison of the gamma nail and the dynamic hip screw,” J of Bone and Joint Surg. 1991;73(2):330–4.
Kumar RM, Rashid MP, Sabarisree MA. Comparative Study of Short Proximal Femoral Nail and Dynamic Hip Screw in Treatment of Intertrochanteric Fractures. J JMSCR 2017;5(6):24195-20019.
Swamy A, Kshirsagar A, Sharma K. Comparative study between dynamic hip screw & proximal femoral nail in treatment of intertrochanteric fracture. Int J Orthop Sci. 2017;3(3):628-75.
Veeragandham P, Sahu RK, Misra S. Comparative study between proximal femoral nailing and dynamic hipscrew with proximal femoral locking compression plates in intertrochanteric fracture of femur. Int J Res Orthop. 2017;3(3):339-49.
Kumar R, Singh RN, Singh BN. Comparative prospective study of proximal femoral nail and dynamichip screw in treatment of intertrochanteric fracture femur. J Clin Orthop Trauma. 2012;3(1):28-36.
Chaitanya M. Comparision of Dynamic Hip Screw and Plate with Proximal Femoral Nail in Trochanteric Fractures of Femur. J Dental Med Sci. 2015;14(4):73-82.
