COMPARATIVE STUDY EFFECTIVENESS OF OF PROXIMAL FEMORAL NAIL WITH HELICAL BLADE VERSUS LAG SCREW IN INTERTROCHANTERIC FRACTURE: A PROSPECTIVE FOLLOW-UP STUDY
DOI:
https://doi.org/10.48047/Keywords:
intertrochanteric fracture, lag screw, helical blade, operative time, and blood lossAbstract
Introduction: Intertrochanteric fractures are defined as extracapsular fractures of the proximal femur that occur between the greater and lesser trochanter and are extremely common fractures occurring in elderly osteoporotic individuals. Although there are multiple studies comparing PFN with other intra-medullary devices like Gamma nail, PFNA, limited studies are available which compares treatment outcomes of proximal femoral nail with lag screw and proximal femoral nail with helical blade.
Objectives of the study: In view of the extremely limited literature available, we conducted this study to compare the effectiveness of PFN with lag screw and helical blade PFN in management of intertrochanteric fracture.
Methodology: We randomized the patients into two groups Group 1: helical blade group and Group 2: lag screw group.. As per new AO/ OTA classification and fracture pattern, cases from both the groups were classified further into stable and unstable and various radiological and functional parameters were assessed accordingly.
Operative protocol: All patients with trochanteric fractures which were operated by two surgeons of our unit were taken on radiolucent table with traction applied on injured limb. In all patient attempt of closed reduction was given on traction table and in fractures where closed reduction was not achieved then fractures were reduced with mini open or percutaneous methods. All cases were provisionally fixed with K wires out of the path of the nail and these k wires were maintained until the nail insertion.
Results: In the present study we found that the operative time, blood loss, follow-up complications were significantly less with better outcomes patients who has undergone helical blade procedure compared to the patients who has undergone lag screw procedure.
The functional outcome calculated using the modified Harris Hip score & Parker and Palmer mobility score, at the end of 12 months, had no significant difference between the two groups.
Conclusion: The observations of the present study indicates that the operative and postoperative functional outcomes are significantly better in helical blade group compared to lag screw group
