COMPARATIVE STUDY BETWEEN PROXIMAL FEMORAL NAILING AND DYNAMIC HIP SCREW FIXATION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 6
Abstract
BACKGROUND Hip fractures are usually common in elderly patients with osteoporosis intertrochanteric fracture accounting for approximately half of the hip fractures in these elderly patients, out of this more than 50% fractures are unstable. Internal fixation is appropriate for most intertrochanteric fractures, because of worldwide acceptance in the last 15 - 20 yrs. Dynamic hip screw (DHS) has behaved as the standard device and considered for comparison of outcomes. Though complications are few Dynamic hip screw has shown good results, specifically in stable intertrochanteric fracture. The proximal femoral nail’s advantage over DHS is that it provides a more biomechanically stable construct, as there is reduced distance between implant and hip joint. In this study, our main aim is to study the radiological and clinical result of PFN and DHS for treatment of intertrochanteric hip fracture, i.e. load sharing vs. load bearing device. The mainstay for treatment of intertrochanteric fracture is fixation with a proximal femoral nail or dynamic hip screw. MATERIALS AND METHODS A comparative study of 2 yrs. duration was conducted on 100 patients admitted in our hospital in Department of Orthopaedics with intertrochanteric fracture. They were treated by proximal femoral nail or with dynamic hip screw. Patients were treated under image intensifier control. The parameters considered in their study are Harris hip score, Duration of surgery, Blood loss during surgery, Intraoperative complication and Implant failure. RESULTS The average age of our patients was 65.2 years in both groups, 20 were male and 30 were female patients. The average blood loss in proximal femoral nail was around 120 mL and dynamic hip screw was around 250 mL. Blood loss is less in PFN which is statistically significant, P value < 0.0001. In PFN was more intraoperative radiation as compared to DHS. The average operating time for PFN was 48 mins and DHS it was around 70 mins, P < 0.0001. The patients with PFN started early mobilisation as compared to DHS, because of better Harris hip score. CONCLUSION In our study, we have found that unstable fracture pattern has better outcome with PFN as compared to DHS. PFN was found to have less operating time as well as less blood loss when compared to DHS. In PFN, early mobilisation is seen as compared to DHS.
Authors and Affiliations
Inder Sain Gupta, Sheetal Sheetal, Anurag Chabra
Keywords
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- EP ID EP399026
- DOI 10.14260/jemds/2018/172
- Views 63
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