scholarly journals A Prospective comparative study of dynamic hip screw and proximal femoral nail for trochanteric fracture femur

Author(s):  
Dr Vijendra Damor ◽  
Author(s):  
Shivanand C Mayi ◽  
Sachin Shah ◽  
Sadashiv R Jidgekar ◽  
Arunkumar Kulkarni

<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


Author(s):  
Mahendra Kumar Reddy Mundla ◽  
Mohammad Rafi Shaik ◽  
Someswara Reddy Buchupalli ◽  
Chandranna B.

<p class="abstract"><strong>Background:</strong> Intertrochanteric (IT) fracture is one of the most common fractures of the femur in the female and elderly with osteoporotic bones, usually due to simple falls. Not many studies compared the treatment of dynamic hip screw (DHS) and proximal femoral nail (PFN), in type II intertrochanteric fractures. Hence, this study was done to compare the management, complications, functional and radiological outcome of PFN with DHS in management of type II intertrochanteric fractures<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> This prospective comparative study was conducted on 60 patients of IT fractures at Santhiram General Hospital, Nandyal, Kurnool (Dist.) during the period May 2016 to September 2017. 30 cases were operated with proximal femoral nail (PFN) and 30 by using dynamic hip screw (DHS). Intraoperative details, complications and outcome of the procedures were noted, compared and analysed statistically.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age in DHS group was 57.5 and PFN group was 56.5 yrs. Female preponderance was observed in the study. Most of the injuries were on right side due to slip and fall in both the groups. Mean radiographic exposure (60 sec) and duration of operation (90 min) were more in PFN group compared to DHS group. Mean blood loss was 230 ml in PFN group and 320 ml in DHS group. Better anatomical and functional results were observed in PFN group compared to DHS group<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> PFN is the better surgical procedure for elderly patients with IT fractures in terms of reduced blood loss, shorter operating time, rotational stability, good fixation, less morbidity and good outcome (anatomical and functional)<span lang="EN-IN">.</span></p><p> </p>


2019 ◽  
Vol 9 (3) ◽  
pp. 65-71
Author(s):  
Sujana Theja J S ◽  
◽  
Kiran Marathe ◽  
B Gurumurthy ◽  
Pavankumar Patted ◽  
...  

Author(s):  
E. S. Radhe Shyam ◽  
K. Ashwin

<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>


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