Functional and radiological outcome of proximal femoral nailing versus dynamic hip screw in unstable intertrochanteric femur fractures

Parikh, Kushal Nikhil; Parmar, Chintan; Patel, Mitesh; Shah, Shalin Bharat

doi:10.18203/issn.2455-4510.intjresorthop20184376

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…In their study of 52 patients, Kushal et al found that the DHS group had outstanding results in six (23 percent), good results in five (19 percent), acceptable results in thirteen (50 percent), and subpar results in two (8 percent). 19 In the PFN group, there were four (15%) cases of outstanding results, fourteen (54%) cases of good results, seven (27%) cases of middling results, and one (4%), case of poor results. In their study of 30 patients, Harish et al reported that in the DHS group, six patients had outstanding results, two had good results, two had acceptable results, and none had poor results.…”

Section: Discussionmentioning

confidence: 89%

Dynamic hip screw versus proximal femoral nail in the treatment of intertrochanteric fracture of femur

Kumar,

Singh,

Khosla

et al. 2023

Int J Res Orthop

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Background: As the elderly population grows, the number of hip fractures continues to increase. This study aims to compare the clinical outcomes of dyanamic hip screw and proximal femoral nail in the fixation of intertrochanteric fracture of femur. Methods: After obtaining approval of the ethics committee, a prospective study was conducted in the department of orthopedics, SKR Hospital, Pathankot from January 2021 till December 2022. Informed consent was taken from patients who fulfilled the inclusion/exclusion criteria and relevant clinical information was collected, including intra and post-operative details. Results: During the study period, 65 patients with intertrochanteric fracture were included in the study, of which 33 were treated with PFN and 32 with DHS. It was observed that 91% of the patients who underwent PFN had blood loss less than 100 ml, while 72% of the patients who had DHS had blood loss between 100-300 ml. Mobilization started on the first postoperative day in 67% of PFN patients while as compared to 13% of DHS patients (p value <0.01). Among late complications, there was one case of implant failure among PFN cases, while there were two cases of non-union, two cases of implant failure and one case of late infection among DHS group of patients. It was observed that 91% of PFN group patients had excellent outcomes, while outcome was excellent in 66% of DHS group patients. Conclusions: Our study showed that PFN is a superior method of osteosynthesis as compared to DHS in the treatment of intertrochanteric fractures.

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Section: Discussionmentioning

confidence: 89%

Dynamic hip screw versus proximal femoral nail in the treatment of intertrochanteric fracture of femur

Kumar,

Singh,

Khosla

et al. 2023

Int J Res Orthop

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“…In a study of 40 patients conducted by Amandeep et al [6], the mean age in the DHS group was 60.3, and that in the PFN group was 56.85. In another study of 52 patients conducted by Kushal et al [7], the mean age in the DHS group was 65, and that in the PFN group was 70.2. Our study has statistics similar to that of Amandeep et al [6].…”

Section: Age Distributionmentioning

confidence: 87%

“…The fair result was attributed to other associated factors namely a long interval between trauma and surgery and the development of postoperative infection. Kushal et al [7] in the study of 52 patients noted that in the DHS group, excellent results were seen in six (23%), good results seen in five (19%), fair results seen in 13 (50%), and poor results seen in two (8%). In the PFN group, excellent results were seen in four (15%), good results seen in 14 (54%), fair results seen in seven (27%), and poor results seen in one (4%).…”

Section: Functional Outcomementioning

confidence: 94%

A Comparative Study of Functional Outcome Following Dynamic Hip Screw and Proximal Femoral Nailing for Intertrochanteric Fractures of the Femur

Prakash¹,

Nagakumar²,

Shanthappa³

et al. 2022

Cureus

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IntroductionIntertrochanteric fractures are common in the old age group. The goal/aim of the treatment for intertrochanteric fractures will be to nearly restore pre-injury condition as early as it is possible. Dynamic hip screw (DHS) and proximal femoral nailing (PFN) have been the two standard treatment methods used for treating these kinds of fractures. The main goal of this proposed study was to compare functional outcomes of two available fixation devices for inter-trochanteric fracture using Harris hip scoring. The aim of this study is to compare the functional outcome of the DHS and PFN for the treatment of Intertrochanteric hip fractures achieved by the patient based on Harris hip score. Methods and materialsThe clinical methodology for the study consists of 46 cases of Inter-trochanteric fractures of femur that meet the inclusion criteria of patients aged above 45 years diagnosed with closed intertrochanteric fractures that are less than three weeks duration who were able to walk prior to fracture and exclusion criteria, admitted to R L Jalappa Hospital, Tamaka, Kolar between November 2019 and November 2021. The patients were divided into two groups, group A treated with DHS and group B treated with PFN and followed up at six weeks, 12 weeks, and 24 weeks based on the functional outcome on the 24 th week using Harris hip score. ResultsA total of 46 patients were included in the study. The mean age in Group DHS was 61.09 ± 11.69 and in Group PFN was 65 ± 14.98. In the group of DHS, nine out of 23 patients were male and 14 out of 23 patients were female patients. In a group of PFN, 12 out of 23 patients were male and 11 out of 23 patients were female. The mean six weeks score in Group DHS was 34.43 ± 3.23 out of 100 and in Group PFN was 34.35 ± 2.5 out of 100. The mean Harris hip score in Group DHS was 84.3 ± 7.68 out of 100. The mean Harris hip score in Group PFN was 89.26 ± 6.53 out of 100. In Group DHS, 52.17% had injuries on the left side and 47.83% had on the right side. In Group PFN, 39.13% had Injury on the left side and 60.87% had on the right side. In Group DHS, results were excellent in 34.78% (eight patients), good in 43.48% (10 patients), fair in 17.39% (four patients out of 23 patients), and poor in 4.35% (one patient). In Group PFN, results were excellent in 56.52% (13 patients), good in 34.78% (eight patients), and fair in 8.70% (two patients). ConclusionFrom the study, it can be concluded that PFN had a better outcome in intertrochanteric fractures compared to DHS. The highest percentage of subjects in the PFN group had excellent to a good outcome and none of them had poor outcomes when compared to the DHS group. PFN group had higher scores of Harris hip score at 12 weeks, 24 weeks, and at the end of follow-up.

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“…In their research, Parikh et al [ 23 ] observed that out of the 52 patients in the DHS group, six (23%) had outstanding outcomes, five (19%) achieved good results, 13 (50%) achieved medium results, and two (8%) achieved bad results. The PFN group exhibited outstanding outcomes in four cases (15%), satisfactory outcomes in 14 cases (54%), moderate outcomes in seven cases (27%), and unsatisfactory outcomes in one case (4%).…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Dynamic Hip Screws and Proximal Femoral Nails in Intertrochanteric Fractures

Thusoo,

Nehru,

Kudyar

et al. 2024

Cureus

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Background Intertrochanteric fractures, which occur in the hip of older individuals due to the weak and brittle structure of the bone caused by osteoporosis, make up over 50% of all hip fractures. There are several treatment options available for these fractures. The major objective of this study was to carry out a comparative analysis to evaluate the efficacy of dynamic hip screws (DHS) and proximal femoral nails (PFN) in treating intertrochanteric fractures. Methodology Two hundred instances of intertrochanteric hip fractures were surgically treated between July 2022 and January 2024 at a tertiary care facility. The evaluation of fractures was conducted in two groups, namely, group 1, which consisted of 140 patients, each having a fracture in one hip, treated using the DHS method. Group 2 consisted of 60 patients, each having a fracture in one hip, treated using the PFN technique. The evaluation of functional results was performed with the Harris hip score. Results In the investigation within these groups, group 1 produced excellent outcomes in 53 patients, which accounts for 37.86% of the total. In group 2, the expected results were achieved in 34 patients (56.67%). Achieved outcomes were favorable in 75 (53.57%) individuals in group 1 and 21 (35%) in group 2. Out of the individuals in group 1, eight (5.71%) saw benefits, whereas four (1.6%) did not gain significantly. In group 2, five (8.33%) individuals benefitted. None of the patients in group 2 had unfavorable outcomes. Conclusion While both PFN and DHS provide comparable outcomes in stable bone, PFN demonstrated superior results in cases of unstable bone. The use of PFN results in reduced surgical duration and a smaller surgical opening. Additionally, PFN exhibited superior specificity compared to DHS, especially in cases with stable intertrochanteric bone.

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Functional and radiological outcome of proximal femoral nailing versus dynamic hip screw in unstable intertrochanteric femur fractures

Cited by 4 publications

References 5 publications

Dynamic hip screw versus proximal femoral nail in the treatment of intertrochanteric fracture of femur

Dynamic hip screw versus proximal femoral nail in the treatment of intertrochanteric fracture of femur

A Comparative Study of Functional Outcome Following Dynamic Hip Screw and Proximal Femoral Nailing for Intertrochanteric Fractures of the Femur

A Comparative Study of Dynamic Hip Screws and Proximal Femoral Nails in Intertrochanteric Fractures

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