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

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

<p class="abstract"><strong>Background:</strong> 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.  </p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.  </p><p class="abstract"><strong>Conclusions:</strong> 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.  </p>

scholarly journals Comparative study between proximal femoral nailing versus dynamic hip screw in unstable inter-trochanteric fractures of the femur in adults

2021 ◽  
Author(s):  
Manoj Kumar ◽  
Zubair A. Lone ◽  
M. Farooq Bhatt ◽  
Abdul Basit
Keyword(s):  
Hip Fractures ◽  
Dynamic Hip Screw ◽  
Harris Hip Score ◽  
Trochanteric Fractures ◽  
Femoral Nailing ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Hip Screw ◽  
Proximal Femoral Nailing ◽  
Unstable Fractures

Background: Hip fractures are more common in elderly among them intertrochanteric fractures are most common, more than 50% fractures are unstable. The proximal femoral nailing (PFN) and dynamic hip screw (DHS) are frequently used modalities from last two decades in both stable and unstable fractures. The DHS has been shown to produce good results but complications are frequent, particularly in unstable inter-trochanteric fracture. The advantage of PFN fixation is that it provides a more biomechanically stable construct with good collapse control. The goal of this study was to compare the clinical and radiographical results of the DHS and PFN for the treatment of inter-trochanteric hip fractures as one is load bearing another is load shearing.Methods: In our study we included 70 inter-trochanteric fractures, out of which 40 were treated with DHS fixation and 30 were treated with PFN, and were followed up at regular intervals of 2 weeks, 8 weeks, 12 weeks, 6 months and annually thereafter.Results: The functional results were assessed with Harris hip score and observed 35% excellent results in DHS group and 63.3% excellent results in PFN group. We observed no statistically significant difference between two groups in view of late and early complications and time to union. We observed significantly better outcomes in PFN group for unstable inter-trochanteric fractures and in unstable fractures reduction loss was significantly lower in PFN group. We observed total duration of surgery was significantly lower in PFN group.Conclusions: We concluded that PFN may be the better fixation device for most unstable inter-trochanteric fractures. 

scholarly journals Functional and radiological outcome of proximal femoral nailing versus dynamic hip screw in unstable intertrochanteric femur fractures

2018 ◽  
Vol 4 (6) ◽  
pp. 861
Author(s):  
Kushal Nikhil Parikh ◽  
Chintan Parmar ◽  
Mitesh Patel ◽  
Shalin Bharat Shah
Keyword(s):  
Functional Outcome ◽  
Outcome Assessment ◽  
Hip Fractures ◽  
Femur Fracture ◽  
Dynamic Hip Screw ◽  
Harris Hip Score ◽  
Femoral Nailing ◽  
Femur Fractures ◽  
Hip Screw ◽  
Proximal Femoral Nailing

<p class="abstract"><strong>Background:</strong> Intertrochanteric femur fractures account half of the hip fractures in elderly, the other majority being neck of femur fracture. 35-40% of intertrochanteric are unstable (Tronzo’s classification type 3, 4 and 5). The dynamic hip screw (DHS) has achieved widespread acclaim in the last few years and is currently considered to be the standard device for outcome assessment. Though, the DHS has been shown to produce good results, but complications are frequent, particularly in unstable inter-trochanteric fracture. The advantage of Proximal Femur Nailing fixation is that it provides a more biomechanically stable construct by reducing the distance between hip joint and implant. The goal of this study is to assess the clinical and radiographical outcomes of the DHS (load bearing implant) and PFN (load sharing implant) for the treatment of Intertrochanteric hip fractures.</p><p class="abstract"><strong>Methods:</strong> We assessed the same in 52 cases of unstable femur fracture 26 operated with DHS and 26 with PFN and followed up with sequential radiographs for radiological union and sequential interview with Harris hip score calculation for functional outcome assessment.<strong></strong></p><p class="abstract"><strong>Results:</strong> Patients operated for unstable intertrochanteric femur fracture with Proximal femoral nailing had better Harris hip scores (excellent 4, good 14) compared to dynamic hip screw group (Excellent 6, good 5) and earlier weight bearing (At 18 weeks, 100% in PFN compared to 65.5% in DHS). PFN has lesser incidence of postoperative complications (15% in PFN compared to 38% in DHS).</p><strong>Conclusions:</strong>The proximal femoral nail has better functional outcome in terms of Harris hip score and early radiologic union in unstable intertrochanteric fractures of femur. <p> </p>

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

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

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Incidence of intertrochanteric fractures has increased significantly during recent years and<strong> </strong>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 &amp; 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)</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This is a randomized prospective study of 102 cases of intertrochanteric fractures,<strong> </strong>admitted to Mysore Medical College &amp; Hospital, Mysore and ESIC medical college and hospital Kalaburagi and Kamareddy Ortho &amp; 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 &amp; 51 were treated with proximal femoral nail (PFN).All patients were followed up for one year</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">In our series of 102 patients of Intertrochanteric fractures, 51 were treated with sliding hip screw with<strong> </strong>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</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">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 &amp; proper positioning of the implant are important to achieve the best post-operative outcome</span><span lang="EN-IN">.</span></p>

scholarly journals Comparative study between proximal femoral nail and dynamic hip screw with trochanteric stabilizing plate in unstable intertrochantric femur fractures

2017 ◽  
Vol 3 (5) ◽  
pp. 936
Author(s):  
Siddaram N. Patil ◽  
Pandurangaiah Srinivas
Keyword(s):  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Unstable Fracture ◽  
Intertrochanteric Fractures ◽  
Femoral Nail ◽  
Hip Screw ◽  
Mobility Score ◽  
Unstable Fractures ◽  
Parker Mobility Score

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Unstable fractures accounts for approximately 50 to 60% of all intertrochanteric fractures. Failure rates of (DHS) dynamic hip screw for unstable fracture patterns are as high as 50%. Proximal femoral nail is technically more demanding surgery and also associated with complications like implant failure, femoral shaft fracture, improper reduction, screw cut-out and non-union. This study was done to compare the results of using Trochanteric stabilization plate in addition to dynamic hip screw versus proximal femoral nail which is considered as a better implant for unstable fractures.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective study was conducted comparing outcomes of proximal femoral nailing versus trochanteric stabilization plate with dynamic hip screw for 44 patients with unstable intertrochanteric fractures (22 each). Harris hip scoring system and Parker mobility score was used for evaluation</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">In our study, Average time of union in all 22 patients of PFN group was about 12 weeks while average time of union in all 22 patients of DHS with TSP group was about 14 weeks. The Harris hip score was 85.45 in DHS with TSP group while it was 84.72 in the PFN group (p=0.846). The Parker mobility score was 7.81 in the DHS with TSP group while it was 7.95 in the PFN group (p=0.728)</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Use of TSP with DHS can give good results in unstable IT fractures. Addition of TSP to DHS gives good lateral wall buttress which prevent excessive medialisation of shaft and gives comparable result to PFN.</span></p>

scholarly journals A prospective comparative study of Proximal Femoral Nailing Anti-rotation (PFNA) and Sliding Hip Screw (SHS) for Per-trochanteric Femur Fracture

2020 ◽  
Vol 24 (2) ◽  
pp. 156-160
Author(s):  
Amer Khan ◽  
Muhammad Ali ◽  
Ayesha Tahir ◽  
Muhammad Saleem ◽  
Usman Sarwar ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Functional Outcome ◽  
Femur Fracture ◽  
Weight Bearing ◽  
Harris Hip Score ◽  
Complication Rates ◽  
Sliding Hip Screw ◽  
Femoral Nailing ◽  
Hip Screw ◽  
Proximal Femoral Nailing

Objectives: To determine the functional outcome, operative risks, rate of union, and complication in Per-trochanteric  Fracture fixed with PFNA and SHS. Material and Methods: The present study has been conducted at Shalamar Medical and Dental College Lahore from January 2018 to December 2018.40 patients with per-trochanteric femur fracture treated with proximal femoral nailing anti-rotation (PFNA)  and Sliding hip screw (SHS) were enrolled in our study.20 patients were treated by PFNA and 20 patients by SHS. Timing of surgery, mobilization status, hospital stay, infection, weight-bearing status, radiological union, complications both technical and implant-related, amount of blood loss(ml), C ARM Exposures, and Harris hip score at the end of 6 months were recorded. Results: Union was better in the PFNA group (95%) as compared to the SHS group (85%). Complication rate, hospital stay, surgery timing, and requirement of revision surgery were more in the SHS group. The functional outcome was better in the PFNA group as compared to the SHS group. Conclusion: From our study, we concluded that PFNA is a better alternative than SHS in terms of higher union rates, low complication rates, and better functional outcomes.  

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