Comparative study between proximal femoral nailing and dynamic hip screw with proximal femoral locking compression plates in intertrochanteric fracture of femur

Background: Intertrochanteric fractures occur in people with poor bone quality, about half of the intertrochanteric fractures are comminuted and unstable. The purpose of the present study was to compare the outcome of surgical treatment of proximal femoral fracture by dynamic hip screw (DHS), proximal femoral nail (PFN) and proximal femoral locking compression plate (PFLCP).Methods: This prospective comparative observational study had included cases presented with intertrochanteric fractures of femur attended orthopedic OPD and emergency department were treated with dynamic hip screw (DHS), proximal femoral nailing (PFN) or proximal femoral locking compression plate. Post-operative x-rays were done to assess reduction and progress of union (non-union/mal-union), any post-operative complications e.g. operative wound infection, implant failure etc.Results: In our study, we found that PFNs prove to be more useful in difficult fractures with a subtrochanteric extension or reversed obliquity. The rotational stability was higher when proximal femoral nail is used in these fractures. The incidence of wound infection was found to be lower with intramedullary implants which resulted in early ambulation of the patients. Conclusions: In our study, we found that proximal femoral nails prove to be more useful in difficult fractures with a sub-trochanteric extension or reversed obliquity. The rotational stability was higher when PFN is used in these fractures. The incidence of wound infection was found to be lower with intramedullary implants which resulted in early ambulation of the patients. Non-union of trochanteric fracture although is a rare entity.

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Comparative functional analysis of intertrochanteric fractures of femur treated with dynamic hip screw with that of proximal femoral nailing

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2017.v3.i4f.58 ◽

2017 ◽

Vol 3 (4f) ◽

pp. 418-421

Author(s):

Dr. Makesh Ram S ◽

Dr. Anand A ◽

Dr. Kathir Azhagan S

Keyword(s):

Functional Analysis ◽

Dynamic Hip Screw ◽

Intertrochanteric Fractures ◽

Femoral Nailing ◽

Hip Screw ◽

Proximal Femoral Nailing

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Comparative study between dynamic hip screw and plate with proximal femoral nailing in trochanteric fractures of femur

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171909 ◽

2017 ◽

Vol 3 (3) ◽

pp. 602

Author(s):

M. K. Nizamoddin Khateeb ◽

Satish Babu D. G.

Keyword(s):

Early Mobilization ◽

Dynamic Hip Screw ◽

Care Hospital ◽

Intertrochanteric Fractures ◽

Sliding Hip Screw ◽

Medical College ◽

Femoral Nailing ◽

Hip Screw ◽

One Year ◽

Proximal Femoral Nailing

Background: Incidence of intertrochanteric fractures has increased significantly during recent years and it will probably continue to rise in near future due to increased longevity of life. Closed methods of treatment for intertrochanteric fractures have increased mortality rates & have largely been abandoned. Rigid internal fixation and early mobilization has been the standard protocol of treatment nowadays. This study was intended to compare the results of Intertrochanteric fractures treated by dynamic hip screw (DHS) over proximal femoral nailing (PFN).Methods: This is a randomized prospective study of 102 cases of intertrochanteric fractures, admitted to Mysore Medical College & Hospital, Mysore and ESIC medical college and hospital Kalaburagi and Kamareddy Ortho & Trauma care Hospital Kalaburagi; treated with proximal femoral nailing and DHS. The patients were divided randomly into two groups, each of 51 patients, 51 were treated by Dynamic Hip Screw & 51 were treated with proximal femoral nail (PFN).All patients were followed up for one year.Results: In our series of 102 patients of Intertrochanteric fractures, 51 were treated with sliding hip screw with plate and 51 were treated by an intra-medullary hip screw. Most of the patients were between 51 to 80 years. Slip and trivial fall accounted for 70% cases. Right side was more common accounted for 58.34% of cases. Conclusions: From our study, we consider PFN as better alternative to DHS in more unstable fractures with technically difficulty and require more experience. Sliding hip screw remains the implant of choice for stable type fractures. We noticed less operative time, less blood loss, fewer intra-op complications in PFN group. The quality of the reduction achieved & proper positioning of the implant are important to achieve the best post-operative outcome.

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A comparative study on the functional outcome of intertrochanteric fractures treated by proximal femoral nailing or dynamic hip screw fixation

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20205559 ◽

2020 ◽

Vol 7 (1) ◽

pp. 51

Author(s):

Gineshmon Chandy ◽

Saju S.

Keyword(s):

Functional Outcome ◽

Dynamic Hip Screw ◽

Harris Hip Score ◽

Intertrochanteric Fractures ◽

Femoral Nailing ◽

Hip Screw ◽

Group 2 ◽

Proximal Femoral Nailing ◽

Radiological Union ◽

Unstable Fractures

Background: Intertrochanteric fractures are one of the commonly occurring injuries in elderly patients and are high among females and those with osteoporosis. They were treated with either dynamic hip screw (DHS) fixation or proximal femoral nailing (PFNA2) here at our institution. The study was conducted in order to find which method of surgical fixation has better functional outcome. Methods: Total 96 patients of intertrochanteric fractures admitted during the study period of November 2017 to April 2019 were included for the study. These patients were randomly divided into two groups; DHS was used as implant in group1 and PFNA2 in group 2. Postoperatively patients were followed up after 1 month, 3months and 6 months of the surgery and were assessed using Harris hip score.Results: Harris hip score was higher with PFNA2 group compared to DHS group in all follow-ups. In unstable fractures DHS group had poor outcome compared to PFNA2. Radiological union occurred in 27.1 % cases by 3 months and 72.9% cases by 6 months with DHS whereas 70.8% and 97.9% respectively with PFNA2. Conclusions: PFNA2 gives a better functional outcome when compared to DHS. Even though DHS gives good functional outcome in stable fractures it is not so in the case of unstable fractures. The radiological union also is faster with proximal femoral nailing. Hence in our opinion PFNA2 can be the better fixation device compared to DHS especially in unstable fractures.

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A comparative study between proximal femur locking compression plate and dynamic hip screw fixation in management of intertrochantric femur fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20164163 ◽

2016 ◽

Vol 2 (4) ◽

pp. 327

Author(s):

Mithlesh Kumar Meena ◽

Vinay Joshi

Keyword(s):

Locking Plate ◽

Locking Compression Plate ◽

Dynamic Hip Screw ◽

Intertrochanteric Fractures ◽

Trochanteric Fractures ◽

Superficial Infection ◽

Femur Fractures ◽

Compression Plate ◽

Hip Screw ◽

The Mean

Background: Proximal femur fractures are one of the commonest fracture encountered in orthopaedic trauma practice. Dynamic hip screw (DHS) is the gold standard procedure for treatment for stable intertrochanteric fractures, however problem arises with unstable fractures in maintenance of neck shaft angle and proper reduction. Here we are giving results of trochanteric fractures treated with proximal femoral locking compression plate (PFLCP) as compared with dynamic hip screw (DHS).Methods: This study was a prospective study. Two groups of trochanteric fractures of 25 patients operated with DHS and LCP were taken. Each patient was followed-up from July 2011 to October 2012 for minimum of 12 month or till the bony union. Every fracture was classified according to AO classification. Functional results will be assessed as per modified Harris hip evaluation score.Results: Among 25 patient treated with PFLCP, length discrepancy was .857 cm while that for DHS was 1.2 cm. The mean time of unaided walking with LCP Was 14.20 weeks while for DHS it was 16.20 weeks. The mean varus angulation for LCP 8 degree while for DHS 10.2 degree. In LCP in 1 case screw cut out from head and neck of femur while in DHS, same is seen in 2 cases and in addition loss of position of lag screw seen in 5 cases.one case was found with superficial infection in LCP while in case of DHS 3 cases with deep infection for that implant was removed and 6 cases were found with superficial infection.Conclusions: Proximal femoral locking plate (PFLCP) is simple, stable for fixation with fewer complications, and is an effective method for unstable intertrochanteric fractures. Comparing with DHS group, the locking plate has shorter operative time, fewer blood loss and drainage.

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