Management of intertrochantric fractures with dynamic hip screw and trochanteric femoral nail - A prospective comparative study
Journal Title: Medpulse International Journal of Orthopedics - Year 2019, Vol 9, Issue 3
Abstract
Background: Intertrochanteric hip fractures account for approximately half of the hip fractures in the elderly and pose a number of management dilemmas depending on the fracture configuration and status of the bones. A wide variety of implants are available for the internal fixation of these fractures ranging from dynamic hip screw which can be combined with trochanteric stabilisation plate; locking plates; intramedullary implants such as proximal femoral nail (PFN), trochanteric femoral nail (TFN) and Gamma nail. A study was undertaken to evaluate the surgical management of intertrochanteric fractures with intramedullary trochanteric femoral nail (TFN) design and dynamic hip screw (DHS) as fixation devices and to determine the rate of union, complications, operative risks and functional outcome and co morbidities associated with intertrochanteric fractures. Materials and methods: The fractures were classified according to Boyd and Griffin classification system. 60 cases of intertrochanteric fracture were managed surgically using Trochanteric femoral nail (n=30) and dynamic hip screw (n=30). The results were analyzed according to age, type of fracture, operative details and final outcome using Kyles criteria. Results: In our study, 30 cases treated with Trochanteric femoral nail had better results than 30 cases treated by Dynamic hip screw, in terms of operating time, surgical exposure, blood loss, range of movements and complication rates. At the final follow-up of 6 months, excellent outcome was seen in 73.3% of patients treated with Trochanteric femoral nail as compared to 56.7% of patients treated with Dynamic hip screw. Conclusion: Trochanteric Femoral nail is a superior implant for stable and unstable intertrochanteric fractures in terms of operating time, surgical exposure, blood loss, and complication rates.
Authors and Affiliations
Sujana Theja J S, Kiran Marathe, B Gurumurthy, Pavankumar Patted
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