Analysis of results of Proximal Femoral Nail(PFN) Versus Dynamic Hip Screw(DHS) in Type 2 Intertrochantric femur fractures

Dr Pathik Vala; Dr Ajay Devda; Dr Mehul Vardey; Dr Tushar Kunder

Volume : V, Issue : X, October - 2016

Analysis of results of Proximal Femoral Nail(PFN) Versus Dynamic Hip Screw(DHS) in Type 2 Intertrochantric femur fractures

Dr Pathik Vala, Dr Ajay Devda, Dr Mehul Vardey, Dr Tushar Kunder

Abstract :

Background Intertrochantric femur fracture is one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to low energy trauma like simple falls. Dynamic hip screws(DHS) is still considered gold standard for treating intertrochantric fracture by many. Not many studies compare the DHS with Proximal Femoral nail(PFN).,in type 2 intertrochantric femur fractures(Boyd and Griffith Classification).This Study was done to compare the functional and radiological outcome of PFN with DHS in treatment of type 2 intertrochanteric femur fracture. Methods From October 2012 to March 2015,a prospective comparative study was done where 30 alternative cases of type 2 intertrochantric fractures of hip were operated using PFN and DHS. Intraoperative complication were noted. Functional outcome was assessed using Harris Hip Score and radiological findings were compared at 3,6 and 12 months postoperatively. Results The average age of patients was 60 years.In our series we found that patients with DHS had increased intraoperative blood loss (150 ml),longer duration of surgery(105 min) and required longer time for mobilisation while patients who underwent PFN had lower intraoperative blood loss(73 ml),shorter duration of surgery(91 min) and allowed early mobilisation. The average limb shortening in DHS group was 9.33 mm as compared with PFN group which was only 4.72 mm. The patients treated with PFN started early ambulation as they had better Harris hip score in the early post–op period. At the end of 12th month, there was not much difference in the functional outcome between the two groups. Conclusion PFN is better than DHS in type 2 intertrochantric femur fractures in terms of decreased blood loss, reduced duration of surgery, early weight be� and mobilisation,reduced hospital stay, decreased risk of infection and decreased complications