Biochemical Markers Comparison of Dynamic Hip Screw and Gamma Nail Implants in the Treatment of Stable Intertrochanteric Fracture: A Prospective Study of 60 Patients

Objectives. To study the correlation between avascular necrosis and the demographics, time elapsed from fracture to surgery, quality of reduction, Garden classification, and the position of the screw following use of the dynamic hip screw (DHS) in the treatment of subcapital neck fractures. Methods. A prospective study of 96 patients with subcapital neck fractures was carried out in a faculty hospital. Patients underwent surgery with closed reduction and internal fixation with DHS. Results. There were 58% male and 42% female patients, with a mean age of 53 years (+/−14). In terms of Garden classification, 60% were Garden IV, 26% were Garden III, and 14% were Garden II. Nonunion was observed in three cases (3%) and was treated with valgus intertrochanteric osteotomy, in all cases leading to successful healing. Avascular necrosis was observed in 16% of patients. The positioning of the screw into the femoral head showed a significant correlation with necrosis. Conclusions. The incidence of necrosis in patients under the age of 50 years is twice as high as that in older patients. Displacement is a predictive factor regarding osteonecrosis and is associated with a high and anterior position of the screw in the femoral head. Level II of evidence. Study Type: therapeutic study.

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Functional outcome of intertrochanteric fractures treated with dynamic hip screw and influence of tad over it - A prospective study

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2017.v3.i1f.64 ◽

2017 ◽

Vol 3 (1g) ◽

pp. 438-440

Author(s):

Naikawadi GH ◽

Bhavi SB ◽

Amith SK

Keyword(s):

Prospective Study ◽

Functional Outcome ◽

Dynamic Hip Screw ◽

Intertrochanteric Fractures ◽

Hip Screw ◽

A Prospective Study

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Comparative prospective study of proximal femoral nail and dynamic hip screw in treatment of intertrochanteric fracture femur

Journal of Clinical Orthopaedics and Trauma ◽

10.1016/j.jcot.2011.12.001 ◽

2012 ◽

Vol 3 (1) ◽

pp. 28-36 ◽

Cited By ~ 16

Author(s):

Ranjeetesh Kumar ◽

R.N. Singh ◽

B.N. Singh

Keyword(s):

Prospective Study ◽

Intertrochanteric Fracture ◽

Dynamic Hip Screw ◽

Proximal Femoral Nail ◽

Fracture Femur ◽

Femoral Nail ◽

Hip Screw ◽

Comparative Prospective Study

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Comparative evaluation of management of intertrochanteric fracture femur with proximal femoral nailing versus dynamic hip screw

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20203730 ◽

2020 ◽

Vol 6 (5) ◽

pp. 1050

Author(s):

Navneet Adhikari ◽

Chandra Shekhar ◽

Ganesh Singh ◽

Hardev Singh

Keyword(s):

Intertrochanteric Fracture ◽

Joint Stiffness ◽

Dynamic Hip Screw ◽

Harris Hip Score ◽

Functional Grade ◽

Fracture Femur ◽

Trochanteric Region ◽

Hip Screw ◽

A Prospective Study

Background: Fractures involving trochanteric region of femur are one of the common fractures affecting elderly population. Presently surgical treatment is the treatment of choice with early mobilisation as primary goal. The two most common implants that are used are Dynamic hip screw (DHS) and Proximal femoral nail (PFN).Methods: This was a prospective study with 50 patients divided randomly into two groups of 25 each. One group operated by PFN and other with DHS. Patients were evaluated periodically and final comparison between two group was done at six months for analysing results on the basis of Harris hip score.Results: At final follow up in patients in PFN group 9 (36%), 7 (28%), 5 (20%), 4 (16%) patients had functional grade in excellent, good, fair and poor category respectively. In DHS group patients, 7 (28%), 10 (40%), 6 (24%), 2 (8%) patients had functional grade in excellent, good, fair and poor functional grade. Harris hip score was insignificantly (p>0.05) lower in patients of PFN (82.68±12.28) than DHS (84.60±10.39).Conclusion: At final follow up we found that pain, limp, use of support while walking and hospital stay was less in PFN group. However, range of motion and hip functions were better in patients treated with DHS. Complications like Varus malunion and infection were common in DHS group while hip joint stiffness was seen more commonly in PFN group. So, both PFN and DHS in are comparable in respect to most of functional criteria for treatment of intertrochanteric fracture femur.

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