A Comparative study of the Dynamic Hip Screw, the Cemented Bipolar Hemiarthroplasty and the Proximal Femoral Nail for the Treatment of Unstable Intertrochanteric Fractures

Abstract

Treatment of unstable IT fracture of femur is a matter open to debate. IT fractures of elderly must be treated with considering the age of the patient, mental status, bone quality, and the type of fracture. according to OCEBM Levels of Evidence Working Group - Level 2.

A study to assess proximal femoral nailing versus dynamic hip screw device in surgical management of intertrochanteric fractures: a comparative study

“…10 In another study by Mansukhani et al, majority of males were present in both groups. 7 The present study findings shows that those who were treated with DHS among them 44.4% were having right side injury while 55.5% were having left side injury. Among those who were treated with PFN 61.1% were having right side injury while 38.8% were having left side injury respectively.…”

“…11 In another study superficial infection was seen in 11% of study participants in DHS group. 7 In one study in DHS group superficial infection was seen in 3.3% study participants. 10 Non-union was seen in 3.3% in PFN group while shortening was seen in 6.6% in DHS group.…”

“…This is dependent on the quality of the bone as well as the type of the implant used for the treatment. 7 The standard treatment for the treatment of trochanteric fractures has been DHS or sliding hip screw (SHS). However, due to a greater distance between the weight bearing axis and the implants, there is a certain biomedical disadvantage.…”

Comparison between Cementless and Cemented Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fractures: Systematic Review and Meta-analysis

“…These conditions not only prolong the treatment period and result in higher medical expenditures, but also create a higher overall socioeconomic cost 3) . Therefore, many studies on the treatment of hip fractures in elderly patients have examined methods for increasing successful treatment outcomes and enabling early ambulation without increasing patient mortality 4 5) .…”

“…Failure rates of unstable intertrochanteric fracture treatment have been decreasing, in part because of the development of various types of proximal nail and surgical techniques that can achieve accurate reduction. However, osteoporosis and cognitive dysfunction of patients still remain major causes of fixation failure as they may make it difficult to achieve strong fixation in the fracture site and interfere with early ambulation 4 , 5) . Consequently, although still debatable, arthroplasty may be considered a preferred approach for treating unstable intertrochanteric fractures 10) .…”