Analysis of the functional and radiological outcome of unstable intertrochanteric femur fractures treated with the proximal femoral nail or the dynamic hip screw

Author(s): Dr. Prunav Adhav Prithvi Raj, Dr. Siva Swaminathan, Dr. Gopi Kumar and Dr. Ponnilavan Krishnan

Abstract: The incidence of intertrochanteric fractures is increasing in frequency in proportion to the increasing life expectancy of the general population. Intertrochanteric fractures are more commonly encountered in elderly osteoporotic patients. Both proximal femoral nailing (PFN) and the dynamic hip screw (DHS) are standard procedures which are being used in the management of unstable intertrochanteric fractures till date. In this study, we analyzed the functional and radiological outcome of treatment of unstable inter trochanteric fractures managed with internal fixation using either the proximal femoral nail or the dynamic hip screw. In our study, we included a total of 35 unstable intertrochanteric fractures (AO-A2 and A3) among which 19 patients were operated with the proximal femoral nail and 16 patients with the dynamic hip screw. It was found that the PFN group faired better than the DHS group, by having lesser time duration of surgery, lower intraoperative blood loss, lower duration of hospital stay, and lower incidence of complications as well. The functional outcome determined by the Modified Harris hip score was also found to be better in the PFN group in the initial post-operative period; however, at the end of one year it was found to be similar in both the groups. There was no statistically significant difference in the radiological outcome determined by the RUSH score (Radiological union score of hip) between the two groups at any point of time from the immediate post-operative period till the entire follow up.

DOI: https://doi.org/10.22271/ortho.2019.v5.i2f.38