Comparison of unstable inter-trochanteric femur fracture treated with Dynamic Hip Screw and Proximal Femur Nail

Muhammad Saleem| Masroor Ahmed| Mukesh Kumar| Khurram Sahar| Ghulam Hussain| Muhammad Bux

Abstract
Objective: To compare the outcome of unstable intertrochanteric fractures managed by proximal femoral nail (PFN) and dynamic hip screw (DHS).
Methodology: The comparative study was done, over the period of two years, involving a total of 108 patients of unstable inter-trochanteric fractures randomly allocated in two groups. One group was treated with DHS, while second with PFN. The outcomes were evaluated in terms of the duration of fracture, duration of surgery, amount of blood loss, limb shortening, union time, wound infection and non-union in both groups.
Results: The mean age of the patients in group A was 60.2±11.37years and in group B was 58.54±11.43 years. The mean duration of fracture in group A and B was 3.61±2.02 and 4.02±1.65 days, respectively. The right side was affected in 36 patients group A and B had 33 patients, while left side in 18 and 21 patients, respectively. Mean duration of surgical procedure in group A was 78.34±17.12 minutes and 70.19±16.14 I group B. Mean time taken for union in group A was 16.85±2.18 weeks while for group B it was 13.67±1.72weeks.
Conclusion: Our study favors PFN over DHS in the treatment of unstable intertrochanteric fractures because PFN fixation significantly reduces intraoperative blood loss, operative time, shortening, infection and union time.

Key words: Dynamic Hip Screw (DHS), intertrochanteric fractures, Proximal Femoral Nail (PFN).

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