Comparison of dynamic hip screw and proximal femoral nail in the treatment of Intertrochanteric fracture of femur

Background: The incidence of inter trochanteric fracture is expected to have doubled by 2040. Inter trochanteric fractures account for about 45% to 50% of all hip fractures in the elderly populationand out of these, near about 50% to 60% are classified as unstable intertrochanteric fractures. The goal of treatment is restoring mobility safely and efficiently, while minimizing the risk of medical complications and technical failure. This study as performed to assess functional outcome with dynamic hip screw and proximal femoral nail in intertrochanteric fracture management.Methods: It was prospective observational study done for a period of 1year from January 2016-January 2017 among patients who attended OPD or emergency department with intertrochanteric fracture. Two different implants were used dynamic hip screw (DHS) and proximal femoral nail (PFN).Results: Excellent results in functional outcome was more in case of PFN (66.6%) compared to DHS (50%). The type of trauma in DHS group was road traffic accident in 38.8%, domestic fall in 50% and others such as assault was in 11.1% while in PFN group intertrochanteric fracture was seen in 61.1% due to domestic fall.Conclusions: The functional outcome was more better with proximal femoral nail (PFN) compared to dynamic hip screw (DHS). Therefore, proximal femoral nail (PFN) should be preferred for management of intertrochanteric fractures.

Download Full-text

Comparison of soft-tissue serum markers in stable intertrochanteric fracture: Dynamic hip screw versus proximal femoral nail—A preliminary study

Injury ◽

10.1016/j.injury.2010.09.008 ◽

2011 ◽

Vol 42 (2) ◽

pp. 204-208 ◽

Cited By ~ 15

Author(s):

Jae-Young Hong ◽

Seung-Woo Suh ◽

Jung-Ho Park ◽

Young-Soo Shin ◽

Jung-Ro Yoon ◽

...

Keyword(s):

Soft Tissue ◽

Intertrochanteric Fracture ◽

Serum Markers ◽

Dynamic Hip Screw ◽

Proximal Femoral Nail ◽

Femoral Nail ◽

Hip Screw ◽

Preliminary Study

Download Full-text

A prospective comparative study in the clinical outcome of trochanteric and subtrochanteric fracture femur with proximal femoral nail versus dynamic hip screw

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20173118 ◽

2017 ◽

Vol 3 (5) ◽

pp. 986

Author(s):

Pradyumna R. Gowda ◽

Manjunath J.

Keyword(s):

Intertrochanteric Fracture ◽

Subtrochanteric Fracture ◽

Dynamic Hip Screw ◽

Proximal Femoral Nail ◽

Fracture Group ◽

Excellent Outcome ◽

Good Outcome ◽

Poor Outcome ◽

Femoral Nail ◽

Hip Screw

Background: Trochanteric fractures are the most common fractures encountered accounting for 50% of all hip fractures. Subtrochanteric femur fractures have high rate of complications associated with their management. 10%–34% of all hip fractures occur in the subtrochanteric region.The study was to compare the clinical outcome of trochanteric and subtrochanteric fracture femur with proximal femoral nail (PFN) versus dynamic hip screw (DHS).Methods: A prospective study of 50 patients with intertrochanteric and subtrochanteric fracture among which 30 were treated with Proximal Femoral Nail and 20 with Dynamic Hip Screw at SSIMS-SPARSH Davangere, Karnataka, India between June 2015 to November 2016. At final follow up results were assessed with Modified Harris Hip score.Results: Among the PFN Intertrochanteric fracture group, 9 patients showed excellent outcome, 6 patients showed good outcome and 2 patients showed fair outcome and 1 patient showed poor outcome. Among the PFN subtrochanteric fracture group, 7 patients showed excellent outcome, 3 patients showed good outcome and 1 patients showed fair outcome and 1 patient showed poor outcome. Among the DHS intertrochanteric fracture group, 3 patients showed excellent outcome, 3 patients showed good outcome and 2 patients showed fair outcome and 2 patient showed poor outcome. Among the DHS subtrochanteric fracture group, 1 patients showed excellent outcome, 2 patients showed good outcome and 3 patients showed fair outcome and 4 patient showed poor outcome. Conclusions: Fractures of the trochanteric region of the femur need a proper selection of implant based on fracture pattern. DHS has excellent results when used on stable fractures. For unstable fractures, PFN is the implant of choice. In case of subtrochanteric fractures PFN has better results in both stable and unstable fractures compared to DHS with less failure rates and restoring better hip biomechanics.

Download Full-text