Evaluation of functional outcome of inter-trochanteric fractures treated with dynamic hip screw and locking compression plate

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20162618 ◽

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

Background: 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.Methods: 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.Results: 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.Conclusions: 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

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Comparison between the outcome of proximal femoral locking compression plate and dynamic hip screw in intertrochanteric femoral fractures

International Surgery Journal ◽

10.18203/2349-2902.isj20213968 ◽

2021 ◽

Vol 8 (10) ◽

pp. 2880

Author(s):

Adnan Arif ◽

Hamza Waqar Bhatti ◽

Noman Ahmed Chaudhary ◽

Abdullah Sadiq

Keyword(s):

Demographic Data ◽

Randomized Study ◽

Femoral Fractures ◽

Locking Compression Plate ◽

Bone Union ◽

Trochanteric Fractures ◽

Implant Complications ◽

Compression Plate ◽

Hip Screw ◽

Better Than

Background: Inter-trochanteric femoral fractures are associated with a high complication rate and mortality. This study aims to compare the proximal femoral locking compression plate (PFLCP) with dynamic hip screws (DHS) for inter-trochanteric femoral fractures in terms of mean bone union time.Methods: It was a prospective randomized study conducted at the department of orthopedics, Benazir Bhutto Hospital, Rawalpindi, Pakistan from June 2015 to December 2015. Sixty patients with a diagnosis of inter-trochanteric fractures, requiring orthopedic surgery, were included in the study. After randomization thirty patients underwent PFLCP fixation and the other thirty patients underwent DHS fixation. Patient information, demographic data, and functional level were assessed. Mean bone union time and implant complications were compared for the two treatment groups.Results: Patients who underwent PFLCP fixation demonstrated shorter bone union time (2.8±0.2 months) than those who underwent DHS fixation (3.2±0.1 months) (p<0.000). PFLCP group had 90% bone union whereas DHS group had 76.66% bone union at 12 weeks (p=0.16). Conclusions: PFLCP is better than DHS for intertrochanteric femoral fractures in terms of shorter mean bone union time and fewer complications.

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A COMPARATIVE STUDY OF FUNCTIONAL OUTCOME BETWEEN DYNAMIC HIP SCREW AND PROXIMAL FEMORAL NAIL IN SURGICAL MANAGEMENT OF PER - TROCHANTERIC FRACTURES

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2015/1087 ◽

2015 ◽

Vol 4 (43) ◽

pp. 7489-7498

Author(s):

Umesh M Shivanna ◽

Girish H Rudrappa

Keyword(s):

Comparative Study ◽

Functional Outcome ◽

Surgical Management ◽

Dynamic Hip Screw ◽

Proximal Femoral Nail ◽

Trochanteric Fractures ◽

Femoral Nail ◽

Hip Screw

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Fixation of Intertrochanteric Fractures: Dynamic Hip Screw versus Locking Compression Plate

Trauma Monthly ◽

10.5812/traumamon.10436 ◽

2013 ◽

Vol 18 (2) ◽

pp. 67-70 ◽

Cited By ~ 5

Author(s):

Mohsen Mardani-Kivi ◽

Ahmadreza Mirbolook ◽

Sina Khajeh Jahromi ◽

Melina Rouhi Rad

Keyword(s):

Locking Compression Plate ◽

Dynamic Hip Screw ◽

Intertrochanteric Fractures ◽

Compression Plate ◽

Hip Screw

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20192689 ◽

2019 ◽

Vol 5 (4) ◽

pp. 707

Author(s):

Hemeshwar Harshwardhan ◽

Sawai Ingh Mali ◽

Manish Sharma

Keyword(s):

Functional Result ◽

Trochanteric Fracture ◽

Good Alternative ◽

Locking Compression Plate ◽

Dynamic Hip Screw ◽

Pertrochanteric Fracture ◽

Harris Hip Score ◽

Bony Union ◽

Compression Plate ◽

Hip Screw

Background: Pertrochanteric fracture is common in elderly people. Dynamic hip screw is still considered the gold standard for treating intertrochantric fracture. Proximal femoral locking compression plate is newer device. The purpose of the study was to compare the outcome of surgical treatment of trochanteric fracture by dynamic hip screw and proximal femoral locking compression plate.Methods: We study 60 patient admitted and followed up at J.L.N. Medical College Ajmer from June 2016 to April 2018 for minimum 6 month or till the bony union. Every fracture classified according to AO classification and functional result will be assessed according to Harris hip score using unpaired t test.Results: The mean operative time and average intraoperative blood loss was more in PFLCP group when compared with DHS group it was statically significant. DHS group has marginally better functional result then PFLCP group. There was no difference in the radiological outcome between two group.Conclusions: DHS is best implant for stable intertrochantric fracture but PFLCP can also be good alternative for unstable IT femur fracture.

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Comparative analysis between dynamic hip screw with trochanteric stabilisation plate and dynamic hip screw alone in the management of unstable intertrochanteric femur fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20204597 ◽

2020 ◽

Vol 6 (6) ◽

pp. 1280

Author(s):

Rajeev Anand ◽

Amit Dwivedi ◽

Anupinder Sharma

Keyword(s):

Comparative Analysis ◽

Functional Outcome ◽

Normal Function ◽

Dynamic Hip Screw ◽

Intertrochanteric Fractures ◽

Trochanteric Fractures ◽

Femur Fractures ◽

Good Score ◽

Hip Screw ◽

Fractures Of The Femur

Background: Intertrochanteric fractures of the femur are difficult to manage because of the complex patterns they present with. A dynamic hip screw (DHS) and a DHS supplemented with a trochanteric stabilisation plate (TSP) are among a variety of fixation methods used in the management of such injuries. We compared the efficacy of DHS with TSP to DHS alone in the treatment of unstable intertrochanteric femur fractures.Methods: 30 patients of intertrochanteric femur fractures (mean age 72 years) were included in the study, 14 were treated using DHS with TSP while 16 were treated using DHS alone, they were followed up till 16 weeks and the progress was recorded according to the parameters in the Salvati and Wilson score.Results: 14 patients were treated using DHS with TSP, 11 of them had excellent Salvati and Wilson scores, 3 patients recorded good scores, 11 patients were able to walk with no pain while 3 needed aids for walking due to pain, normal function was restored in 12 patients while very little restriction was seen in 2 patientsOf the16 patients treated using DHS alone, 10 had excellent scores, 6 recorded a good score, 10 patients walked with no pain while 6 needed aids for walking due to pain, normal function was re-stored in 11 patients, very little restriction was seen in 4 patients while 1 patient had restricted nor-mal activity.Conclusions: DHS with TSP appears to provide better fixation and functional outcome in unstable inter trochanteric fractures over DHS alone.

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Outcome of dynamic hip screw with trochanteric stabilizing plate in treatment of unstable intertrochanteric femoral fractures in elderly patients.

The Professional Medical Journal ◽

10.29309/tpmj/2022.29.01.3433 ◽

2021 ◽

Vol 29 (01) ◽

pp. 31-35

Author(s):

Muhammad Asif ◽

Yaqoob ur Rehman ◽

Sardar Sohail Afsar

Keyword(s):

Elderly Patients ◽

Functional Outcome ◽

Femoral Fractures ◽

Trochanteric Fracture ◽

Dynamic Hip Screw ◽

Harris Hip Score ◽

Trochanteric Fractures ◽

Poor Functional Outcome ◽

Hip Screw ◽

Study Setting

Objective: To know about the outcome of dynamic hip screw with trochanteric stabilizing plate in treatment of unstable inter-trochanteric femoral fractures in elderly patients. Study Design: Descriptive study. Setting: Maqsood Medical Complex, Pak Medical Centre and Habib Medical Complex. Period: August 2016 to July 2018. Material & Methods: Total of 70 patients with unstable inter-trochanteric fracture and age above 60 years were included in the study. The fracture was fixed with dynamic hip screw and trochanteric stabilizing plate. Patients were evaluated every month after surgery for healing of fracture. Final functional outcome was measured at 6 months after surgery with Harris Hip Score. Results: Out of 70 patients 44 (63%) were females and 26 (37%) were males. Mean age was 74.34(SD + 08.31) years with range of 60 to 87 years. Mean Harris Hip Score at 6 months was 85% with standard deviation of± 4.Ten (14%) patients had excellent, 40 (58%) patients had good, 16 (23%) patients fair and 4 (5%) patients poor functional outcome. Conclusion: Excellent and good functional outcome can be achieved in unstable inter-trochanteric fractures fixed with dynamic hip screw and trochanteric stabilizing plate in majority of patients.

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

Journal of International Medical Research ◽

10.1177/147323000903700410 ◽

2009 ◽

Vol 37 (4) ◽

pp. 1057-1064 ◽

Cited By ~ 48

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.

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