Abstract: Background: Intertrochanteric fractures have the highest postoperative fatality rate amongst surgically treated fractures, they have become an important health issue and thus it is very important to study and compare different surgical options available for these fractures. So purpose of the study to compare postoperative follow up in the management of intertrochanteric fractures of femur a comparative study using dynamic hip screw and proximal femoral nail.
Material & Methods: Patients with pathologic fractures, patients with multiple fractures, patients with old neglected, fractures, fractures in paediatric age group, fractures in elderly patient with high medical risk for anesthesia and surgery, reverse intertrochanteric fractures were included in the study. The post-operative pain was also assessed as per the Harris Hip Score criteria at the end of 1 year and the post-operative gait was also assessed at the end of 1 year. Union was decided on the basis of obliteration of fracture line with bridging callus so as to allow unprotected function of the limb.
Observation & Results: At 1 year follow up, 9 patients had no pain, 5 had minimal pain, 6 had moderate pain and only 1 patient had severe pain post operatively in the DHS group, while 12 patients had no pain, 8 had minimal pain and 3 had moderate pain post operatively in the PFN group. The functional outcome was better for PFN than for DHS however, the difference was not statistically significant (p value >0.05). Conclusion: Thus it was concluded from this study that P.F.N. has the following advantages over D.H.S. in the treatment of intertrochanteric fractures (especially unstable fractures). Lesser operative time, lesser blood loss, early post-operative rehabilitation of the patients, better functional outcome. However, the difference in the functional outcome is not statistically significant and thus we require a larger group of study to prove the significance.
