Comparative study between proximal femoral nailing and dynamic hip screw with proximal femoral locking compression plates in intertrochanteric fracture of femur

Abstract

<p class="abstract"><strong>Background:</strong> Intertrochanteric fractures occur in people with poor bone quality, about half of the intertrochanteric fractures are comminuted and unstable. <span>The purpose of the present study was to compare the outcome of surgical treatment of proximal femoral fracture by dynamic hip screw (DHS), proximal femoral nail (PFN) and proximal femoral locking compression plate (PFLCP)</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span>This prospective comparative observational study had included cases presented with intertrochanteric fractures of femur attended orthopedic OPD and emergency department were treated with dynamic hip screw (DHS), proximal femoral nailing (PFN) or proximal femoral locking compression plate. Post-operative x-rays were done to assess reduction and progress of union (non-union/mal-union), any post-operative complications e.g. operative wound infection, implant failure etc</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study, we found that PFNs prove to be more useful in difficult fractures with a subtrochanteric extension or reversed obliquity. The rotational stability was higher when proximal femoral nail is used in these fractures. The incidence of wound infection was found to be lower with intramedullary implants which resulted in early ambulation of the patients<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> In our study, we found that proximal femoral nails prove to be more useful in difficult fractures with a sub-trochanteric extension or reversed obliquity. The rotational stability was higher when PFN is used in these fractures. The incidence of wound infection was found to be lower with intramedullary implants which resulted in early ambulation of the patients. Non-union of trochanteric fracture although is a rare entity<span lang="EN-IN">.</span></p>

A study to assess proximal femoral nailing versus dynamic hip screw device in surgical management of intertrochanteric fractures: a comparative study

“…9 In one study majority of the study participants were in the age group of 40-60years in both the groups accounting for 40%. 11 In present study majority of study participants in both the groups were males, in DHS (66.6%) and PFN (77.7%) respectively. Present study findings were consistent with other studies were 90% of males were seen in DHS group and 75% males were in PFN group.…”

“…Present study findings were consistent with other studies were 90% of males were seen in DHS group and 75% males were in PFN group. 11 In a study done by Swamy et al, 56% were males in DHS group and 50% males were in PFN group. 10 In another study by Mansukhani et al, majority of males were present in both groups.…”

“…In another study domestic accident were the etiological factor for intertrochanteric fracture in both the group DHS (65%) and PFN group (45%). 11 In a study done Kumar et al,68.8% had domestic fall while 31.3% were having road traffic accident. 9 In present study, 38.8% of the study participants were having type-III intertrochanteric fracture among those who were treated with DHS while 33.3% were having type-IV intertrochanteric fracture who were treated with PFN.…”

“…9 In Veergandham et al, study in DHS group 70% were having right side injury and in PFN group 35% were having right sided injury. 10,11 The type of trauma in DHS group was road traffic accident in 38.8%, domestic fall in 50% and others such as assault was in 11.1% while in PFN group intertrochanteric fracture was seen in 61.1% due to domestic fall which is more than DHS group which was followed by 33.3% due to road traffic accident and 5.5% due to other reasons. In another study domestic accident were the etiological factor for intertrochanteric fracture in both the group DHS (65%) and PFN group (45%).…”

Proximal femoral nail: A boon for peritrochanteric fractures

“…08% patients were partially weight bearing. Veeragandham et al in a study of 108 patients with a peritrochanteric femoral fracture, fixed using the proximal femoral nail, observed that the patients had regained their pre-operative walking ability significantly (p = 0.04) by the four-months [23] . Only 12% patient had moderate pain and only 04% had severe pain.…”