Comparative study of functional outcome of the intertrochanteric fracture of femur managed by Dynamic hip screw and proximal femoral nail

Abstract

Introduction: Intertrochanteric (IT) femur fractures comprise approximately half of all hip fractures. These fragility hip fractures occur in a characteristic population with risk factors including increasing age, female gender, osteoporosis, a history of falls, and gait abnormalities. Although the effects of PFN and DHS in treatment of intertrochanteric fractures have been reported, the results and conclusions are not consistent.Materials and Methods: This Comparative Prospective study was conducted in a tertiary care institute ELMCH for a period of 18 months from January 2017 to June 2018. Every case with intertrochanteric fracture was treated randomly (computer generated number table) either by Dynamic hip screw(DHS) or Proximal femoral nail(PFN). A total of 80 cases were included. The patients were further divided into two groups, each of 40 cases, 40 were treated by Dynamic Hip Screw & 40 were treated with proximal femoral nail (P.F.N). All patients were followed up for nine months.Results: In our study the mean age in the PFN group was 62.5 while in the DHS group it was 64 years. In present study the intergroup comparison of Harris Hip score between PFN and DHS group revealed that post operatively after 1 month the Harris hip score in PFN group had mean value 32.95±2.65, while the HH score in DHS group had mean 22.30±0.65. Post operatively after 3 month the Harris hip score in PFN group had mean value 57.33±2.10, while the HH score in DHS group had mean 51.90±0.96. Post operatively after 6 month the Harris hip score in PFN group had mean value 83.50±0.96, while the HH score in DHS group had mean 73.73±3.30.Conclusion: Therefore, the study showed that PFN is better method of fixation in intertrochanteric fracture of femur.