The best treatment for trochanteric fracture remains controversial Many methods have been recommended. Stable fixation that allows early mobilization is the treatment of choice. In this study, we aimed to compare the results of osteosynthesis using the PFNA and DHS system, in the treatment of stable intertrochanteric fractures including operative and postoperative complications, general complications and final outcome measurements.
Method: We randomised 60 patients with low-energy extracapsular pertrochanteric stable femoral fractures (AO category 31-A1.1-31A.2.1)7 to be treated with the dynamic hip screw or the proximal femoral nail A2. All fractures were categorised according to the AO/ASIF classification. Follow-up reviews were undertaken at four weeks, three and six months post-operatively using Harris hip score.
Results: From the first to the 6th month, there was a significant improvement in Harris hip score (p<0.05), when each time point was compared with the previous one in both groups. On 3 -month follow-up, PFNA2 group had significantly better daily functioning than DHS group, as defined by Harris hip score. At 6 months, the PFNA2 group approached but did not normalise to its pre-operative Harris hip screw values (p =0.043). In contrast, DHS group values at 6 months lagged significantly to pre-operative values (p<0.001) PFNA group has fewer complications compared to DHS group.
Conclusion: PFNA can benefit peritrochaneric fractures with less blood loss, earlier mobilization, better functional outcome and fewer complication compared to DHS.