Functional and radiological outcome of intertrochanteric fracture in patients treated with dynamic hip screw and proximal femoral nail

Author(s): Dr. Antony Vimalraj M, Dr. Vinodh Rajkumar P, Dr. Dalton J and Dr. Kathir Azhagan S

Abstract: Background: The aim of the study was to assess the functional and radiological outcome of intertrochanteric fracture in elderly patients treated with dynamic hip screw or proximal femoral nail.
Materials and Methods: The study was conducted in Government Stanley hospital, from May 2014 to December 2015. A total of 98 cases of intertrochanteric fractures in age group of 55 to 65 years admitted were included in our study. Patients with pathological fracture was excluded. The 98 patients were divided into stable and unstable groups using Evans classification. DHS was done for 56 of them and PFN for another 42 of them and results were evaluated. The mean duration of surgery, mean blood loss and mean length of incision, intraoperative complications, time of weight bearing were evaluated. The Harris hip score was used to evaluate the hip joint function.
Results: Most of the patients in our age group were between 55 to 65 years around 80%. The mean duration of surgery, mean blood loss and mean length of incision was more in DHS group then PFN group. We came across more intraoperative complications in PFN group then DHS group. Time of weight bearing was more in unstable fracture in DHS group. The Harris hip score was in favour of PFN at six weeks after surgery but it became same in both groups after 20 weeks of surgery.
Conclusion: PFN has advantage of smaller incision, less blood loss and less morbidity. The short lever arm and lower bending moment in PFN may add mechanical advantage to the construct which makes it the implant of choice in osteoporotic bones. Deformity and complications was less in PFN group in our study. Rate of fracture union was similar in both groups with early mobilization in PFN group, DHS found to be the implant of choice for stable fracture but for unstable fracture PFN is the better choice.

DOI: https://doi.org/10.22271/ortho.2017.v3.i4f.57