A comparative study to evaluate clinical outcome in patients of age above 50 years with intertrochanteric fractures of femur treated with either by PFN (proximal femoral nail) or DHS (dynamic hip screw)

Abstract

Introduction: Intertrochanteric fractures are the most common, especially in elderly people with osteoporotic bones. They typically occur as a result of low-energy trauma, such as a simple fall. There is a bimodal age distribution for hip fractures. Only 3% of patients under the age of 50 years, while 97% of patients over 50 years of age. The goal of this study is to compare PFN and DHS outcomes and
complications when treating patients with unstable intertrochanteric fractures. Methods and Methodology: This study consists of 30 cases of intertrochanteric fractures of femur that met the inclusion exclusion criteria, which randomly divided into group A and group B.
Results: Anatomical results were assessed by the presence or absence of shortening, the range of movements and deformities.73.33% of these cases had good results in PFN series as compared to 66.66% in DHS series. Functional results were assessed in the 30 cases based on modified harris hip scoring system. These constituted of 15 cases in PFN series and 15 cases in DHS series. In PFN Series,
results were excellent results in 11 cases, good in 4 cases. In DHS Series, results were excellent in 7 cases, good in 6 cases and poor in 2 cases.
Conclusion: In the light of these results, one can conclude that the proximal femoral nail, despite a few unfavorable results and complications, it is a satisfactory method of treatment in intertrochanteric fractures, with Comminution and instability. Results with intramedullary devices have been very good with union ratesupto 100% compared with other extra medullary devices which show union upto 80% only. The nail in the medullary canal provides a physical block to a significant shortening of the head and neck segments in the fractures.