Surgical Management of Intertrochanteric Fractures : A Study Using Dynamic Hip Screw and Proximal Femoral Nail

Abstract

OBJECTIVES:The aim of this study was to compare the outcome of intertrochanteric fractures treated with Dynamic Hip Screw and Proximal Femoral nail. METHODS: This study was conducted on 80 cases of Intertrochanteric fractures of femur treated by a dynamic hip screw and proximal femoral nail. Patients were operated on standard fracture table under image intensifier control. RESULTS: The average age of the patient was 63.2 years. Most common mechanism of fracture was domestic fall. The unstable pattern was more common in old aged patients with higher grade of osteoporosis. The average blood loss was 240 and 320ml in PFN and DHS group respectively. In PFN there were more no. of radiation exposure intraoperatively. The average operating time for the patients treated with PFN was 100min as compared to 80 min in patients treated with DHS. No complications of non-union and infection. In the PFN group the amount of sliding on X-rays was less as compared to DHS. The patients treated with PFN started early ambulation as they had better Harris Hip Score in the early period (at 1 and 3 month). In the long term both the implant had almost similar functional outcomes. CONCLUSION: From the study, we concluded PFN is better alternative to DHS in management of intertrochanteric fractures but is technically difficult procedure and requires more expertise compared to DHS.

Evaluation of neck shaft angle achieved immediately after surgical fixation of intertrochanteric fracture

“…High velocity trauma is one of the commonest causes trochanteric fractures in the younger population, whereas often a trivial trauma results in trochanteric fractures in the elderly population. Trochanteric fractures are more common in the female population compared to the male due to osteoporosis [3] . The dynamic hip screw (DHS) is one of the most widely used and successful implants for the treatment of stable intertrochanteric fractures with the controlled sliding and collapse concept.…”