Minimal Invasive Dynamic Hip Screw Versus Proximal Femoral Nailing In Treatment Of Inter-Trochanteric Fractures- A Comparative Study
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2018, Vol 4, Issue 1
Abstract
Background: Inter-trochanteric fractures can be managed efficiently by fixation with Proximal femoral nail (PFN) which is intramedullary and has advantages like maintaining controlled impaction, lower rates of implant failure, shortening and deformity, shorter operative time, less soft tissue dissection and bleeding compared to fixation using Dynamic Hip Screw (DHS). Objective: To compare the surgical outcomes of Internal fixation with Proximal femoral nail with Dynamic Hip Screw in patients with Intertrochanteric fractures. Methodology: This prospective comparative study was conducted at Puducherry from May 2015 to May 2017 among 30 adult patients of Intertrochanteric fractures of femur randomly allocated for either of the two operative procedures viz: internal fixation with Proximal Femoral nail (15 cases) and Minimal invasive Dynamic Hip screw (15 cases). The surgical outcomes were compared in terms of intra-operative and post-operative variables as well as delayed outcomes during follow-up till radiological bone union was documented. Results: The mean age of the study participants was 55.7 ± 2.7 years and majority (53.3%) was females. The mean duration of surgery was shorter (52.1minutes in PFN versus 69.9 minutes in DHS), mean blood loss was minimal (97.5 ml versus 163 ml), mean duration of stay in hospital was less (16.2 days versus 16.8 days), time of weight bearing was faster (3.6 weeks versus 9.5 weeks) and mean duration of fracture union was shorter (15.2 weeks versus 19.9 weeks) in PFN compared to DHS. Conclusion: The fixation of inter-trochanteric fractures with PFN is a better operative procedure compared to DHS in terms of reduced operating time, minimal blood loss, higher stability, early mobility, less morbidity and favorable outcomes both anatomically and functionally.
Authors and Affiliations
Amudha Ganesh S, Balasubramanium S, Rajesh R, Arun Daniel J
Keywords
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