Comparison of Dynamic Hip Screw and Proximal Femoral Nailing Techniques in Stable Intertrochanteric Fractures

Shiraz, Salman; Shujauddin, Mohammad; Hasan, Khalid; Elramadi, Ahmed; Ahmed, Ghalib

doi:10.7759/cureus.33366

Cited by 3 publications

(3 citation statements)

References 23 publications

(35 reference statements)

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“…In younger people, high-energy trauma is a common cause of intertrochanteric fractures. Various categories have been suggested, such as the Boyd and Griffin classification from 1949 [3], the Evans classification, and the AO classification [4,5].…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study of Dynamic Hip Screws and Proximal Femoral Nails in Intertrochanteric Fractures

Thusoo,

Nehru,

Kudyar

et al. 2024

Cureus

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Background Intertrochanteric fractures, which occur in the hip of older individuals due to the weak and brittle structure of the bone caused by osteoporosis, make up over 50% of all hip fractures. There are several treatment options available for these fractures. The major objective of this study was to carry out a comparative analysis to evaluate the efficacy of dynamic hip screws (DHS) and proximal femoral nails (PFN) in treating intertrochanteric fractures. Methodology Two hundred instances of intertrochanteric hip fractures were surgically treated between July 2022 and January 2024 at a tertiary care facility. The evaluation of fractures was conducted in two groups, namely, group 1, which consisted of 140 patients, each having a fracture in one hip, treated using the DHS method. Group 2 consisted of 60 patients, each having a fracture in one hip, treated using the PFN technique. The evaluation of functional results was performed with the Harris hip score. Results In the investigation within these groups, group 1 produced excellent outcomes in 53 patients, which accounts for 37.86% of the total. In group 2, the expected results were achieved in 34 patients (56.67%). Achieved outcomes were favorable in 75 (53.57%) individuals in group 1 and 21 (35%) in group 2. Out of the individuals in group 1, eight (5.71%) saw benefits, whereas four (1.6%) did not gain significantly. In group 2, five (8.33%) individuals benefitted. None of the patients in group 2 had unfavorable outcomes. Conclusion While both PFN and DHS provide comparable outcomes in stable bone, PFN demonstrated superior results in cases of unstable bone. The use of PFN results in reduced surgical duration and a smaller surgical opening. Additionally, PFN exhibited superior specificity compared to DHS, especially in cases with stable intertrochanteric bone.

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Section: Introductionmentioning

confidence: 99%

A Comparative Study of Dynamic Hip Screws and Proximal Femoral Nails in Intertrochanteric Fractures

Thusoo,

Nehru,

Kudyar

et al. 2024

Cureus

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“…Intertrochanteric fractures (ITFs) are considered serious traumas, often seen in the elderly population and can lead to severe consequences such as pneumonia, pulmonary embolism, morbidity, or even death. [1][2][3][4] The importance of achieving anatomical correctness in the treatment of ITFs cannot be overemphasized, as lack of it can result in shortness of extremities, varus and external rotation deformities. 5,6 The primary objective of ITF surgery is to provide stabilization to ensure safe movement and loading on the fracture in the reduction position, thereby allowing early ambulation and rehabilitation for the patient.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Computer aided analysis of biomechanical performance of schanz screw with different additive manufacturing materials used in pertrochanteric fixator on an intertrochanteric femoral fracture (corrosion resistance approach)

Gok,

Urtekin,

Gok

et al. 2023

Numer Methods Biomed Eng

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This study examines the use of computer‐aided analysis to evaluate the biomechanical performance of Schanz screws made from different additive manufacturing materials (Ti6Al4V, 316 L, Inconel 625, and Inconel 718) in a pertrochanteric fixator for the treatment of intertrochanteric femoral fractures. Intertrochanteric fractures (ITFs) are severe traumas often seen in the elderly population and can lead to serious consequences. The primary objective of ITF surgery is to provide stability and allow for early ambulation and rehabilitation. The Pertrochanteric Fixator is a surgical implant used to treat hip fractures near the greater trochanter, and is attached to the femur with screws. The procedure is performed under general anesthesia and typically takes 1–2 h. Possible complications include infection, nerve injury, and hardware failure. The aim of this study is to evaluate the biomechanical performance of Schanz screw using computer‐aided analysis, comparing the effects of various additive manufacturing materials including Ti6Al4V, 316 L, Inconel 625 and Inconel 718 in a pertrochanteric fixator for intertrochanteric femoral fractures. Additionally, this study will also consider the corrosion resistance of these materials to ensure long‐term durability and effectiveness in a clinical setting. The stress values mentioned for the implant materials are as follows. Ti6Al4V: 153.33 MPa, 316 L: 180.98 MPa, Inconel 625: 158.94 MPa, Inconel 718: 148.91 MPa. Higher stress values indicate a greater load transfer to the bone, which can potentially lead to stress shielding. Stress shielding occurs when an implant bears a significant portion of the load that should be transferred to the bone. This reduced stress at the fracture site can prevent the healing process, as bones require adequate stress levels for optimal remodeling and regeneration.

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Comparative Analysis of Functional Outcomes: Extramedullary Versus Intramedullary Fixation in Unstable Inter-Trochanteric Femoral Fractures

Bhatti,

Mirjat,

Abro

et al. 2024

PJHS

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Unstable trochanteric femoral fractures are challenging to manage. Two options exist for the operative treatment and management of unstable trochanteric fractures; i.e. extramedullary or intramedullary stabilization. However, there is a dearth of good evidence of the clinical efficacy of either of the two methods especially in terms of functional outcomes. Objective: To compare the functional outcome following fixation of unstable trochanteric femoral fractures via extramedullary versus intramedullary methods. Methods: This prospective cohort was conducted upon 46 adult patients and admitted at Liaquat University Hospital Hyderabad/Jamshoro, after taking written informed consent from parents. Functional outcomes utilizing the Timed Up and Go Test and Harris Hip Score, at 3 months and 6 months post-surgery and radiographic parameters were gathered to evaluate heterotopic ossification and femoral neck shortening at follow-up visits using a pre-structured questionnaire. The data was analyzed with SPSS V.21 and Microsoft Excel 2016. Results: The sample predominantly consisted of males, with a mean age of 31 ± 5 years. Intramedullary fixation showed superior early mobility outcomes and maintained better hip function scores compared to extramedullary fixation for unstable inter-trochanteric femoral fractures. Intramedullary fixation also demonstrated lower rates of heterotopic ossification and less femoral neck shortening, indicating potential benefits in reducing complications and preserving anatomical integrity. Conclusions: In conclusion, the study findings suggest intramedullary fixation as a favorable option for optimizing functional recovery and radiographic outcomes in such fractures

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Comparison of Dynamic Hip Screw and Proximal Femoral Nailing Techniques in Stable Intertrochanteric Fractures

Cited by 3 publications

References 23 publications

A Comparative Study of Dynamic Hip Screws and Proximal Femoral Nails in Intertrochanteric Fractures

A Comparative Study of Dynamic Hip Screws and Proximal Femoral Nails in Intertrochanteric Fractures

Computer aided analysis of biomechanical performance of schanz screw with different additive manufacturing materials used in pertrochanteric fixator on an intertrochanteric femoral fracture (corrosion resistance approach)

Comparative Analysis of Functional Outcomes: Extramedullary Versus Intramedullary Fixation in Unstable Inter-Trochanteric Femoral Fractures

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