Vol. 11, Issue 3 (2025)

Background: Intertrochanteric fractures in the elderly pose a significant clinical challenge, frequently resulting in extended disability and increased mortality rates. Determining the most effective fixation method to promote early mobilization and minimize complications is therefore a critical concern. This study aims to determine the superiority of the Dynamic Hip Screw (DHS) over the Proximal Femoral Locking Plate (PFLP) in the management of these fractures.

Methods: A prospective, comparative study was conducted at Orthopedic Department from 2020 to 2024. This research focused on a select group of 18 cases, all above the age of 60, with intertrochanteric fractures. These cases were classified into two groups: Group A (PFLP), and Group B (DHS). Hip Rating Score was used to assessed outcomes. Follow-up assessments were conducted at predetermined intervals after the surgery. The initial evaluation took place the day after the procedure, followed by a second assessment at 14 days to observe early recovery and identify any immediate complications. The final evaluation was performed at three months to assess long-term outcomes.

Results: The preoperative analysis for both arms shown no significant differences in age, symptoms, hospital stay, anticoagulant drugs, and energy trauma. A significant difference in the duration of operation, with Group A longer duration than Group B (P=0.02). Group B reported a quick recovery as a statistically significant faster time to starting weight bearing (P=0.01). HRS between Group A and Group B, showed no significant overall in mean scores. For Group A, most fractures in good HRS more than Group B. Group B more excellent than A, with a significant difference in fracture stability and fixation technique (p=0.01). Both groups showed the same rate of varus deformity. Cases of Group A experienced pain doubled than Group B.

Conclusions: Both proximal femoral locking plate (PFLP) and dynamic hip screw (DHS) fixation methods yielded comparably favorable outcomes in the treatment of stable intertrochanteric fractures. However, DHS demonstrated certain advantages, including reduced operative time and a lower incidence of postoperative complications such as infections and hip discomfort which superior to PFLP.