COMPARATIVE ANALYSIS OF OPERATIVE TREATMENT OF SUBTROCHANTERIC FEMUR FRACTURES TREATED WITH LONG PFN, ANGLE BLADE PLATE AND DHS

Dr. Kishore Raichandani; Dr. Madhu Sudan Sharma; Dr.Ashok Singhvi; Dr. Hemant Jain; Dr. Nitin Goyal; Dr. Divya Garg

Volume : VII, Issue : IV, April - 2018

COMPARATIVE ANALYSIS OF OPERATIVE TREATMENT OF SUBTROCHANTERIC FEMUR FRACTURES TREATED WITH LONG PFN, ANGLE BLADE PLATE AND DHS

Dr. Kishore Raichandani, Dr. Madhu Sudan Sharma, Dr. Ashok Singhvi, Dr. Hemant Jain, Dr. Nitin Goyal, Dr. Divya Garg

Abstract :

INTRODUCTION: This study was conducted to evaluate the outcome of operative treatment of subtrochanteric femur fracture and comparative analysis of clinical outcome of fixation with three different implants.

METHOD: This study was conducted at tertiary care hospital from August 2015 to June 2017. Patients with subtrochanteric femur feacture were treated with three implants ABP, DHS, Long PFN, 25 patients were selected randomly for each of these implants. Fracture was classified according to Seinsheimer�s classification, there were 12 type1, 23 type2, 19 type4 and 21 type5 fractures. For operative procedure fracture table was used , in case of ABP/DHS– 1^st fracture was converted into two piece if comminution was present and guide wire was inserted opposite to level of Lesser trochanter, screw was kept within 2cm of subchondral bone. For Long PFN 1^st reduction was done and then entry was made through modified medial portal and reduction was maintained till proximal and distal locking. Minimum follow up was 12 months.

RESULTS: Average surgery time was 60 minutes for PFN and 90 Minutes for ABP/DHS. Average healing time was 16 weeks. Results based on Harris hip score: 92% were excellent and good for ABP and 96% for DHS and PFN. One case of screw cut out was there with DHS and one case of eakage of implant with ABP.

CONCLUSION: Operative treatment should be done in fracture of subtrochanteric femur fracture though we did not found any difference in clinical outcome and fracture union among ABP, DHS and Long PFN but more quantitative and long follow up studies are needed.