A surgical management of pertrochanteric fractures of femur by dynamic hip screw and proximal femoral nail

Author(s): Dr. KV Dhanwantary Naidu

Abstract: The incidence of femoral fractures at hip region is increasing with advancement of age in population, globally. Surgical treatment with stable fixation reduces fracture associated complications and helps in regaining of mobility. Dynamic hip screw (DHS) and proximal femoral nail (PFN) are main types of fixations for trochanteric fractures. This study was designed to assess the efficacy of DHS and PFN in trochanteric fractures of femur. A total 50 patients with type I, II, III intertrochanteric and subtrochanteric fractures of femur as per Boyd and Griffin’s classification, Seinsheimer’s classification and Evans classification were included and were managed operatively by internal fixation with dynamic hip screw (DHS) and proximal femoral nail (PFN). 48% cases in DHS and 44% cases in PFN undergone with surgery within 5 days after injury. In PFN, the range of lag screw length was between 70mm to 95mm whereas in DHS, range was in between 65mm to 100mm. In intra operative complications of this study, there was ill fitting jig in 24% cases of PFN and in DHS method includes shattering of lateral cortex (8%) and difficulty in reduction (8%). Average time for fracture union in this study was between 14-17 weeks. In 12% cases varus deformity was observed in both groups and on an average 82% cases had good range of movement at hip joint in PFN and DHS groups. It was concluded that proximal femoral nail and dynamic hip screw were ideal treatment modalities to treat inter trochanteric and sub trochanteric fractures of the femur.

DOI: https://doi.org/10.22271/ortho.2018.v4.i1f.56