Surgical Management of Unstable Intertrochanteric Fractures of Femur with Proximal Femoral Nail versus Dynamic Hip Screw Fixation: A Comparative Study

摘要

Background: The intertrochanteric fractures are most common injuries in patients over sixty years of age. Also it is occur in people with poor bone quality, about half of the intertrochanteric fractures are comminuted and unstable. The purpose of present study was to evaluate and compare the clinical, radiological and functional outcomes of patients with unstable intertrochanteric fractures of femur treated with proximal femoral nail versus dynamic hip screw.Method: Total 60 patients were enrolled in the study. 30 patients were treated by proximal femoral nail (PFN) and 30 patients were treated by dynamic hip screw (DHS). Intraoperative details, early and late complications were recorded and the functional outcome of each group was assessed using the Harris Hip Score (HHS) and compared statistically.Results: Union rate was better in PFN group (96.6%) as compared to DHS group (86.6%), (p0.05). Complication rate and requirement of revision surgery was more in DHS group, (p0.05). Post-operative blood transfusion was significantly more in DHS group i.e. 40% as compared to PFN group 6.6% , (P 0.05). The functional outcome was found to be more in PFN group as compared to DHS which was statistically very highly significant.Conclusion: PFN is better than DHS in terms of higher union rates, low complication rate, less blood transfusion and good functional outcome. Thus, it is better fixation device especially in unstable intertrochanteric fracture.