To evaluate the clinical outcome and compare the advantages, disadvantages and possible complications associated with fixation of intertrocantric fractures with proximal femoral nail (PFN) and hemiarthroplasty.
Introduction: Surgery in trochanteric fractures is important in elderly patients for prevention of complications associated with conservative treatment like pressure sores, pulmonary infection, malunion etc, and aimed at early rehabilitation and mobilization. Internal fixation does provide immediate fracture fixation. The present study was undertaken to compare outcomes of reduction of intertrochanteric fractures using internal fixation with the use of PFN and bipolar hemiarthroplasty (BPH) in elderly patients. This study compares bipolar hemiarthroplasty with proximal femoral nail (PFN) in ambulatory elderly patients, focusing on functional results and return to premorbid level of activity. Treatment modality like DHS is time tested but with availability of better hemiarthroplasty techniques and implant, mortality and morbidity can be reduced. This study was undertaken to compare clinical outcomes of intertrochanteric fractures treated with PFN compared to bipolar hemiarthroplasty (BPH) in elderly patients
Methodology: A Prospective Comparative Study was conducted in 20 elderly patients who were admitted and operated between November 2013 to November 2015 and had fulfilled the inclusion /exclusion criteria. They were allocated into two groups 10 patients each for PFN and BIPOLAR PROSTHESIS as group A and group B respectively. Harris hip score was used for assessment of the results of surgery. The results thus obtained was analysed and compared.
Results: 8 of the 10 patient treated with PFN and 9 of the 10 patient treated with Bipolar regained their pre injury walking ability at the fourth month of follow-up. Patients treated with PFN had a significantly lower pain score at the sixth month of follow up. The outcomes of the stable fractures treated with either Bipolar or PFN were similar. Unstable comminuted fractures treated with Bipolar showed significantly better outcomes with all patients having good results.