Title: Management of unstable inter-trochanteric fractures by Dynamic Hip screw versus Proximal Femur Nailing- A Comparative Analysis
Authors: Dr Surendar Singh Bava, Dr Tushar Kadam
DOI: https://dx.doi.org/10.18535/jmscr/v5i9.13
Abstract
Background: The aim of this study was to compare the outcomes of proximal femoral nail (PFN) and dynamic hip screw (DHS) in treatment of unstable intertrochanteric fractures.
Material and Methods: In our study, we included 80 unstable intertrochanteric fractures, out of which 40 were treated with PFN and 40 were treated with DHS. The surgeries were performed on traction table and were followed up at regular intervals at 2 weeks, 4 weeks, 6 months and annually thereafter.
Results: The functional results were evaluated with Harris Hip Score. At most recent follow up, Patients with excellent results were 23 (46%) in group A and 20 (36%) in group B while patients with good results were 15(28%) in group A and 20(45%) in group B. Differences were observed to be statistically significant difference between two groups in view of late & early complications and time to union. Better outcomes were noted in PFN group for unstable intertrochanteric fractures.
Conclusions: We concluded that PFN may be the better fixation device for most unstable inter-trochanteric fractures.
References
- Melton L J, Kearns A E, Atkinson E J et al. Secular Trends in Hip Fracture Incidence and Recurrence, Osteoporosis International; 2009; 20(5): 687- 694.
- Gullberg B, Johnell O, Kanis A. World Wide Projection for Hip Fracture, Osteo-porosis International; 1997; 7(5):407-413.
- Hardy D, Descamps P, Krallis P 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, The Journal of Bone & Joint Surgery 1998; 80: 618-630
- Carter D, Hayes W. The Compressive Behavior of Bone as a Two-Phase Porous Structure, The Journal of Bone & Joint Surgery 1977; 59A (7): 954-962.
- Nuber S, Schoweiss T, Ruter A. Stabilization of unstable trochanteric femoral fractures: dynamic hip screw with trochanteric stabilization plate vs Proximal femoral nail, Journal of orthopaedic trauma 2003; 17(4): 316-317.
- Steinberg E L, Nehemia N H, Shmuel D L et al. The proximal femur nailing system: biomechanical properties of the nail and a cadaveric study, Journal of Biomechanics; 2005; 38: 63-68.
- M Faisal, P Nistane. Proximal Femoral Nailing vs. Dynamic Hip Screw in unstable IntertrochantericFracture of Femur – A comparative analysis, International Journal of Biomedical and Advance Research
- Rockwood and Green’s Fractures in Adults Eighth Edition, Wolters Kluwer
- Campbell’s Operative Orthopaedics, Twelfth edition, Elsevier Publishers