scholarly journals A study to assess proximal femoral nailing versus dynamic hip screw device in surgical management of intertrochanteric fractures: a comparative study

2018 ◽  
Vol 5 (1) ◽  
pp. 23
Author(s):  
E. S. Radhe Shyam ◽  
K. Ashwin
Keyword(s):  
Functional Outcome ◽  
Intertrochanteric Fracture ◽  
Trochanteric Fracture ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Technical Failure ◽  
Intertrochanteric Fractures ◽  
Femoral Nail ◽  
Fracture Management ◽  
Hip Screw

<p class="abstract"><strong>Background:</strong> 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<strong> </strong>to assess functional outcome with dynamic hip screw and proximal femoral nail in intertrochanteric fracture management.</p><p class="abstract"><strong>Methods:</strong> 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).<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

Dynamic Hip Screw versus Proximal Femoral Nail in the Management of Intertrochanteric Fractures - A Retrospective Analysis from Rajasthan

2021 ◽  
Vol 8 (26) ◽  
pp. 2271-2277
Author(s):  
Gajanand Shriram Dhaked ◽  
Abhishek Komalsingh Jaroli ◽  
Khushboo Parmanand Malav ◽  
Harish Narayan Singh Rajpurohit
Keyword(s):  
Functional Outcome ◽  
Functional Outcomes ◽  
Statistical Significance ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Final Decision ◽  
Intertrochanteric Fractures ◽  
Femoral Nail ◽  
Duration Of Surgery ◽  
Hip Screw

BACKGROUND Current management of Intertrochanteric (IT) fractures has evolved with the introduction of dynamic hip screw (DHS) and proximal femoral nail (PFN). The purpose of this study was to compare the functional outcomes between the DHS and PFN for IT fracture fixation. METHODS This study is a retrospective comparative analysis of 455 patients with IT fractures; DHS (292) and PFN (163), who were treated from June 2012 to June 2015. The patients were reviewed postoperatively for a minimum of 12 months to evaluate functional outcome using Salvati-Wilson score. Categorical data was present as absolute number or percentages, and parametric variables were presented as Mean ± SD, while non parametric data were presented as median. Statistical significance was defined as P < 0.05. RESULTS Intramedullary nails offer no advantage over extramedullary devices to treat IT fractures caused by low-energy trauma (AO 31 - A1). However, clinically significant outcomes were established for PFN group in terms of duration of surgery, x- ray exposure and SW Score for AO / OTA 31 - A2 and 31 - A3. Reoperations encountered for local pain due to implant prominence were significantly higher in the PFN group (4.90 % versus 1.02 %). Kaplan Meier survival probability of 69.3 % and 79.5 % predicted for DHS and PFN respectively, 3 years postoperatively. CONCLUSIONS Our conclusion reinforces indication for PFN in unstable IT fractures (31 - A2 and 31 - A3), owing to its better functional outcome and biomechanical properties. Functional outcomes for stable IT fracture (AO 31 - A1) were comparable between DHS and PFN, therefore final decision for implant choice depends on implant cost, surgeon’s preference for specific technique. However, understanding the morphology of proximal femur, peritrochanteric region is crucial to analyse the anatomical variations in Indian population which will provide the basis for intramedullary nail design modifications. KEYWORDS Intertrochanteric Fractures, DHS Fixation, PFN Fixation

scholarly journals Randomized comparative study to evaluate the role of proximal femoral nail and dynamic hip screw in unstable trochanteric fractures

2016 ◽  
Vol 2 (3) ◽  
pp. 75
Author(s):  
Shivanand C Mayi ◽  
Sachin Shah ◽  
Sadashiv R Jidgekar ◽  
Arunkumar Kulkarni
Keyword(s):  
Comparative Study ◽  
Functional Outcome ◽  
Trochanteric Fracture ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Trochanteric Fractures ◽  
Stable Fixation ◽  
Femoral Nail ◽  
Duration Of Surgery ◽  
Hip Screw

<p class="abstract"><strong>Background:</strong> Treatment of unstable trochanteric fracture is much more challenging than stable fracture. These fractures require stable fixation to minimize the fracture and implant related complications. Need of this study is to assess the suitable implant for stable fixation of unstable trochanteric fracture with less intra and postoperative complications and good functional outcome.</p><p class="abstract"><strong>Methods:</strong> In this prospective randomized comparative study, 64 patients were distributed into two groups. Group A consisted of patients treated by proximal femoral nail (PFN) (n=32) and group B treated by dynamic hip screw (DHS) (n=32). All the patients were evaluated preoperatively and surgery was done according to the group they were allotted. Post-operative follow up was done at 6 weeks, 3, 6 and 12 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Average age of the patients in this study was 51.26±10.24 year. In this study patients were followed up for an average of 10.87±2.61 month. The duration of surgery was shorter in PFN group. Weight bearing was earlier in PFN group than DHS group. Mean functional ability score was better in PFN group with significant gain in function earlier as compared to DHS group.</p><strong>Conclusions:</strong> PFN is a better implant for internal fixation of unstable trochanteric fractures which allows early mobilization and has got better functional outcome score in early postoperative period than DHS

A Comparison of Proximal Femoral Nail Antirotation and Dynamic Hip Screw Devices in Trochanteric Fractures

2009 ◽  
Vol 37 (4) ◽  
pp. 1057-1064 ◽  
Author(s):  
J Zou ◽  
Y Xu ◽  
H Yang
Keyword(s):  
Functional Outcome ◽  
Trochanteric Fracture ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Trochanteric Fractures ◽  
Femoral Nail ◽  
Operation Rate ◽  
Significant Difference ◽  
Hip Screw ◽  
Proximal Femoral Nail Antirotation

This prospective, randomized study compared the functional outcome and complications associated with a proximal femoral nail antirotation (PFNA) device with those of a traditional extramedullary device, the dynamic hip screw (DHS), in patients with trochanteric fracture. A total of 121 patients were randomized to the PFNA group ( n = 58) or the DHS group ( n = 63). Perioperative information and complications were recorded, and assessments of functional outcome were made. The DHS group required a longer operative time and was associated with greater blood loss than the PFNA group. The re-operation rate was lower in the PFNA group compared with the DHS group, especially in patients with unstable fractures, although there was no statistically significant difference in the overall complication rate between the two groups. There were no significant differences in functional outcome between the PFNA and the DHS groups. In conclusion, the PFNA device is useful in the treatment of trochanteric fractures.

scholarly journals Dynamic Hip Screw with Trochanter-Stabilizing Plate Compared with Proximal Femoral Nail Antirotation as a Treatment for Unstable AO/OTA 31-A2 and 31-A3 Intertrochanteric Fractures

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Chun-Wei Fu ◽  
Ji-Ying Chen ◽  
Yueh-Ching Liu ◽  
Kuang-Wen Liao ◽  
Yung-Chang Lu
Keyword(s):  
Intertrochanteric Fracture ◽  
Operation Time ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Residual Pain ◽  
Unstable Intertrochanteric Fracture ◽  
Hip Screw ◽  
Proximal Femoral Nail Antirotation ◽  
Im Nailing

Background. The dynamic hip screw (DHS) with the addition of an angular stable trochanter-stabilizing plate (TSP) has been considered the ideal treatment for the unstable intertrochanteric fracture type. However, there have been few comparisons between DHS+TSP augmentation with intramedullary (IM) nailing. The aim of this retrospectively registered study was to compare the clinical outcomes of patients with the unstable type of intertrochanteric fractures treated with DHS+TSP or IM nailing (proximal femoral nail antirotation (PFNA)). Methods. From June 2013 to April 2018, 358 patients with proximal femur fracture AO/OTA type 31A2 and 31A3 treated with PFNA or DHS+TSP and followed for ≥10 months postoperatively were included. The surgical-dependent outcome evaluation included the operation time, intraoperative blood loss, postoperative decrease in hemoglobin, and blood transfusion amount. Functional status was also measured. Radiographic findings and postoperative complications were recorded and analyzed. Result. The operation time was significantly shorter in the DHS+TSP group than that in the PFNA group for both A2 and A3 fractures (A2 type: 84.0 vs.96.4 min; p<0.05; A3 type: 102.4 vs.116.1 min; p<0.05). Postoperative decrease in hemoglobin was more significant in the PFNA group than that in the DHS+TSP group for both fracture types (A2 type: −1.88 vs. −1.29 (mg/dL); p<0.05; A3 type: −1.63 vs. −1.04 (mg/dL); p<0.05). However, the patients treated with DHS+TSP had significantly more residual pain than those treated with PFNA during the final follow-up (Visual Analog Scale score, A2 type: 28.4 vs.23.2; p<0.05; A3 type: 27.5 vs.23.6; p<0.05) and complained of greater implant irritation. Conclusion. We found that DHS+TSP was associated with less operation time and less postoperative decrease in hemoglobin but more residual pain and implant irritation than those of PFNA. As a treatment for unstable intertrochanteric fracture, DHS+TSP provided ideal surgical outcomes which were not inferior to the PFNA.

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

Injury ◽  
2011 ◽  
Vol 42 (2) ◽  
pp. 204-208 ◽  
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
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