A comparative evaluation of results of proximal femur nail and dynamic hip screw fixation for intertrochanteric femur fractures

Author(s): Dr. Ashok Vidyarthi MS, Dr. Ashish Sirsikar MS and Dr. Aashish Raghu MS

Abstract: Incidence of intertrochanteric femur fractures has increased significantly during the recent decades, due to the change in the demographic profile of Indian population. Conservative management of these fractures has shown higher mortality and morbidity and has largely been abandoned. Rigid Internal fixation and early mobilization is the standard method of treatment.
Objective: To verify the advantages and disadvantages of the proximal femur nail over the dynamic hip screw device and also their effect on the eventual functional outcome of the patient.
Methods: This is a retrospective and prospective comparative analytical study of 30 cases of intertrochanteric femur fractures admitted in Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur from January 2011 to November 2014. 15 cases were treated by PFN and 15 by DHS. Patients were followed up at 3 months, 6 months and 1 year. The results were compared for functional outcome by modified Harris Hip Score.
Results: In our study of 30 patients, there were 4 female and 26 male. Minimum age was 24 years, maximum 70 years with mean age of 46.1 years. Most of the cases sustained fracture by trivial trauma. 60% of the fractures were unstable. More duration of surgery, more blood loss, more number of radiation exposure, more chances of infection was seen with PFN, whereas more screw backout, more chances of varus & valgus non-union was seen with DHS.
Conclusion: PFN had better functional outcome in patients with especially unstable fractures and DHS had better functional outcome among the stable fractures.

DOI: https://doi.org/10.22271/ortho.2018.v4.i2d.34