Abstract
PROXIMAL FEMORAL NAILING VS. DYNAMIC HIP SCREW IN UNSTABLE INTERTROCHANTERIC FRACTURE OF FEMUR – A COMPARATIVE ANALYSIS

Dr. K. Vivek*

ABSTRACT

Intertrochanteric (IT) fractures occurs approximately half of the hip fractures in elderly; among this, more than 50% fractures are unstable. The Dynamic Hip Screw (DHS) had gained widespread acceptance in previous decades. Dynamic Hip Screw has produce good results but complications are frequent and most commonly in unstable intertrochanteric fracture. The Proximal Femur Nailing (PFN) fixation provides a more biomechanically stable construct by reducing the distance between hip joint and implant. The goal of this study is to compare the clinical and radiological outcomes of DHS and PFN for the treatment of unstable Intertrochanteric hip fractures. In our study we included 20 unstable intertrochanteric fractures, in that 10 were treated with Proximal Femur Nailing and 10 were treated with Dynamic Hip Screw. All surgeries were done on traction table and were followed up at regular intervals at 6 weeks, 8 weeks, 12 weeks, 6 months and annually thereafter. The functional results assessed with Harris Hip S core. At latest follow up, Patients with excellent results were 6 (66%) in group A and 3(36%) in group B while patients with good results were 3(28%) in group A and 3(54%) in group B. We statistically observed significant difference between two groups in view of early and late complications and time to union. We obrseved significantly better outcomes in Proximal Femur Nailing group for unstable intertrochanteric fractures and reduction loss is significantly lower. We concluded that Proximal Femur Nailing device may be the better fixation for most unstable intertrochanteric fractures.

Keywords: Intertrochanteric fractures, proximal femoral nail and dynamic hip screw.


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