Proximal Femoral Nailing Vs Dynamic Hip Screw For Intertrochanteric Fractures – A Comparative Clinical Study
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2017, Vol 3, Issue 2
Abstract
Intertrochanteric fractures are one of the common fractures encountered in today's orthopaedic practice. Over time, a number of implants have been used for the same. Multiple studies have been conducted in the past to study the advantages and disadvantages of the proximal femoral nail and the dynamic hip screw. However, the ideal choice of the implant remains a matter of debate. This study deals with the comparison of the Proximal femoral nailing (PFN) versus Dynamic hip screw (DHS) in treatment of Intertrochanteric fractures. Methods: This study was conducted from October 2015 to August 2017. During this period 30 cases of adult patients with intertrochanteric fractures of femur were selected according to the inclusion criteria and classified according to the AO classification. Of the 30 cases,16 were operated using a proximal femoral nail and 14 were operated using dynamic hip screw. Aims: To assess the functional outcome and radiological outcome in cases of Intertrochanteric fractures treated with proximal femoral nailing and dynamic hip screw. And to study and compare the intra-operative parameters in both modes of treatment like duration, blood loss, radiological exposure. Methods and Material: A prospective study was conducted from 2015 to 2017 during which 30 cases of Intertrochanteric fractures that fulfilled the inclusion criteria were operated either using Proximal femoral nailing or dynamic hip screw. The choice of implant was chosen randomly. The AO/OTA classification system was used to classify the fractures.3 Conclusions: Our study shows that Proximal Femoral Nailingis a superior procedure in terms of lesser operative time, lesser blood loss, smaller incision, lesser post operative shortening but radiographic exposure is more compared to the Dynamic Hip Screw.Patient operated with PFN, being an intra-medullary implant, could fully weight bear without pain at significantly earlier as compared to those by DHS.However, long term results are equivalent for both. PFN is a more preferred implant for intertrochanteric fractures, especially for unstable pattern types. In cases of stable pattern fractures, PFN and DHS both have similar results.
Authors and Affiliations
Santosh Bindhumadhavan, Sudhir Sharan, Rajib Naskar, Harshad Argekar
Keywords
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