Evaluation of Various Methods of Trochanteric Fracture Fixation and Their Comparison- A Prospective Study

Abstract

BACKGROUND Trochanteric fractures are devastating injuries that most commonly affect the elderly and also the young; they have tremendous impact on both the health care system, and society in general. 1 The mainstay of the treatment of intertrochanteric fractures is fixation with DHS, intramedullary device, and proximal locking compression plate. The aim of the present study was to compare the result in terms of rate of union, time of ambulation and functional recovery of fracture intertrochanteric femur treated by either dynamic hip screw (DHS), proximal femoral interlocking nail (PFN) or proximal locking compression plate (PFLCP). METHODS This was a prospective study of 62 patients, 20 patients were treated by PFN (Group A), 32 cases were treated by DHS (Group B) and 10 cases treated by PFLCP (Group C). All Patients were followed up at 1 month, 3 months, 6 months and 1 year. Results were compared for functional outcome by using Harris Hip Score. RESULTS Comparison of Harris hip score at 12-month-follow-up period revealed that PFN group to be significantly more mobile (PFN-94.8 vs. DHS-90.8 vs. PFLCP-89.3). p-Value for PFN vs. DHS group is 0.12, p value for PFN vs. PFLCP is 0.073 (>0.05) and p value for DHS vs. PFLCP is 1.00. All p values show insignificant difference in functional outcome of patients. It shows that most of patients achieved approximately same level of functional outcome at the end of one year. CONCLUSIONS PFN is a biomechanically good device for fixation of comminuted intertrochanteric fracture femur. PFN allows faster mobilization, early rehabilitation, lower implant failure rate, and faster union as compared to DHS and PFLCP. In our study, PFLCP seems to be feasible alternative to PFN and DHS in certain complex, unstable, comminuted trochanteric fractures when weight bearing was restricted till radiological signs of fractures healing are seen. HOW TO CITE THIS ARTICLE: Singh G, Gautam S, Ahmed N, et al. Evaluation of various methods of trochanteric fracture fixation and their comparison-a prospective study.