Comparison of post-operative hip abductor muscle strength and functional outcome between dynamic hip screw and proximal femoral nail in intertrochanteric fracture

Abstract

Extra capsular intertrochanteric femur fractures occur between femoral neck and lesser trochanter of the femur. However, this study aims to study the influence of restoration of femoral offset in relation to the strength of the hip abductor muscle along with the functional outcomes. In patients with ≥18 years of age that were operated for Intertrochanteric fracture and referred for physiotherapy, a prospective cohort study was performed. On the principles of deep venous thrombosis (DVT) prevention, strengthening exercises, ROM exercises and gait training the patients were given physiotherapy. Once weight bearing was allowed on 6 weeks, their gait parameters (stride length, cadence), functional strength (Unilateral stance test) and Harris Hip Score were measured. The same outcome measures along with the strength of hip abductor muscle were repeated at 6 months as femoral offset is important for restoring anatomy. In conclusion, weak hip abductor muscle strength was exhibited in patients with unrestored femoral offset and better outcomes were reported in patients with Dynamic Hip Screw fixation in comparison to other surgeries in young population. Additionally, the functional status of the patients with more than 70 years of age remained poor in comparison to the younger patients post-operatively.