To Compare and Assess Dynamic Hip Screw and Proximal Femur Nail in Intertrochenteric Femur Fracture
Author(s): Vivek Amritbhai Patel, Chintan Bharatbhai Sheth*, Sangeen Bhundiya, Sangeen Bhundiya, Saurabh Rajeshbhai Patel, Adarsh Vishnubhai Patel and Deep Manojbhai Pavani
Introduction: Intertrochanteric fractures of femur are one of the commonest musculoskeletal injuries in patients of above sixty years age group because of trivial fall and osteoporotic nature of bones. Different studies have been showing controversial results between Dynamic Hip Screw & intramedullary fixation devices historically. Aim: Aim of our study is to compare functional and clinical outcome of dynamic hip screw (DHS) and intramedullary proximal femoral nail (PFN) in intertrochanteric femur fractures. Material & Methods: Our study included (n=50) patients with intertrochanteric fracture of femur from which (n=25)50% patients operated with DHS and other (n= 25)50% patients operated with PFN. In our study average age of patient was 63years. Most common mode of injury was trivial fall and 54% patients were female. There were (n= 28)56% stable & (n= 22) 44% unstable fractures out of 50 intertrochanteric fractures. Results: Mean duration of surgery, blood loss during surgery and length of incision were less in PFN group than DHS group. Fluoroscopy time is higher in PFN group than DHS group. Postoperative shortening was more in DHS group and postoperative range of motion was better in PFN group. Union time is faster in PFN group. Malunion was seen in (n=5) 20% patients of DHS group while there were (n=2)8% cases of malunion in the PFN group. Wound infection was seen in (n=3) 12% patients in the DHS group and in (n=1)4% patient in the PFN group. Conclusion: At the end of the study we came with the conclusion that in stable intertrochanteric fracture DHS & PFN had similar results but in case of unstable fracture PFN was significantly better in terms of functional and clinical outcomes.