DYNAMIC HIP SCREW VS PROXIMAL FEMORAL NAIL IN SURGICAL MANAGEMENT OF TROCHANTERIC FRACTURES: A PROSPECTIVE COMPARATIVE STUDY

SOMP. GUPTA; ARJUN S.RATHORE

Volume : VIII, Issue : VI, June - 2019

DYNAMIC HIP SCREW VS PROXIMAL FEMORAL NAIL IN SURGICAL MANAGEMENT OF TROCHANTERIC FRACTURES: A PROSPECTIVE COMPARATIVE STUDY

Somp. Gupta, Arjun S. Rathore

Abstract :

Introduction: Trochanteric fractures are the commonest hip fractures specially in elderly. Present study aimed to evaluate and compare the operative characteristics, radiological and functional outcome and incidence of complications with Dynamic Hip screw (DHS) and proximal Femoral Nail (PFN) used in surgical correction of Trochanteric fractures. Material and Methods: A Randomized comparative study was conducted at department of orthopaedics, at a tertiary care centre of Northern India. Thirty patients of with trochanteric fractureswere randomized to eitherDHS or PFN group. Follow up evaluation was done at 1, 3 and 6 months. Functional outcome was assessed using ‘Harris hip score’. Results: Mean age of patients was 62.47±20.73 years. Fall was responsible for 56.7% of fractures. Mean Operating time (p<0.001), blood loss (p=0.004), radiation exposure (p=0.025) and mean duration of hospital stay were significantly more in DHS group. Callus at 3 cortex was seen in more subjects in PFN group (93.33%) as compared to DHS group (53.33%) at one month, however all patients in both group had callus formation at 3 months. Pain score was significantly less in PFN group at 1 & 3 months follow up. All patients in PFN group were able to walk without support at 3 months, whereas only 10 (66.7%) patients did so in DHS group. Harris Hip score was significantly higher in PFN at one month. Time to return to work was significantly less in PFN group.Incidence of infection, varus deformity and limb length disparity was more with DHS. Conclusion: Though PFN had operative and early post operative advantages, final success rate at 6 months was similar in both groups. Choice between the two methods needs to be individualized considering their merits and demerits