A prospective comparative evaluation of proximal femoral nailing and dynamic hip screw in treatment of intertrochanteric fracture in tertiary care hospital

Abstract

Back ground: Intertrochanteric fractures are extra capsular fractures of the proximal femur that occurs between greater and lesser trochanter. This fracture comprises of half of the all hip fracture which occurs due to low energy mechanism, and is likely to increase. Intramedullary nailing is used to treat a broader range of intertrochantric fracture, it is less invasive, blood loss is less, and allow early weight bearing. But there are very few data suggesting that intramedullary nailing hip screw is more of effective than dynamic hip screw. Material and method: A sample size of 60 was selected for this study using purposive sampling technique. All patients were evaluated as history and mode of injury, radiological evaluation of fracture, and haematological profile was done. For pre injury walking ability evaluation Sahlstrand classification was used. X-ray AP and lateral view of hip was taken. Bohler -Braun frame was used to put skin traction. General condition of all patients was evaluated and corrective measure was taken. Fracture was classified based on Jensen and michealsen's modification of Evans classification. Result: Regarding intra operative variables as per table-2, the mean duration of surgery in group A was 63.23+9.27 min in group B it was 87.866 + 4.15 min, The P value was 0.0001 The mean amount of blood loss 136 +40.46ml in group A and 385+74.42ml in group B. The P value was 0.0001. In group A mean of length of incision was 9.4+ 1.246mm and in group B it was 14.48+0.94cm. The P value was 0.0001. Discussion and conclusion: Based on our observation we can conclude that intra operative profile is better in proximal femoral nailing then dynamic hip screw. The blood loss was less, duration of surgery was less and the size of incision was less in proximal femoral nailing. Proximal femoral nailing has better out come in terms of early mobilisation of patient.