Comparison of dynamic hip screw and proximal femoral nail in the treatment of Intertrochanteric fracture of femur

Abstract

Introduction: As the elderly population grows, the number of hip fractures continues to increase. This study aims to compare the clinical outcomes of DHS and PFN in the fixation of intertrochanteric fracture of femur.

Methodology: After obtaining approval of the ethics committee, a prospective study was conducted in the Department of Orthopedics, DY Patil School of Medicine from January 2014 till December 2015. Informed consent was taken from from patients who fulfilled the inclusion/exclusion criteria and relevant clinical information was collected, including intra and post-operative details. The patients were called for followup to check for complications.

Results: During the study period, 50 patients with intertrochanteric fracture were included in the study, of which 23 were treated ith PFN and 27 with DHS. 76% of the PFN patients needed no blood transfusion, while 41% of DHS patients needed 2 units of blood transfusions. Post operative fever and deep vein thrombosis was more common in DHS patients. 79% of PFN patients started mobilizing on the first postoperative day as compared to 68% of DHS patients who starting mobilizing on third postoperative day. Similarly post operative weight, full weight bearing and return to activity of daily living was seen to be better in PFN patients.

Conclusions: Our study showed that PFN is a superior method of osteosynthesis as compared to DHS in the treatment of intertrochanteric fractures. Future research should focus on studying the economic and rehabilitative impact of PFN on patients with intertrochanteric fractures.