A comparative study of dynamic hip screw and proximal femoral nail in the management of intertrochanteric fractures of femur

Abstract

Background: The aim of this study was to compare the outcomes of proximal femoral nail (PFN) and dynamic hip screw (DHS) in treatment of intertrochanteric fractures. Material and Methods: This was a prospective study conducted between June 2016 and June 2018. The total numbers of cases included in our study was 50 which were equally divided into two groups: one operated with DHS and other with PFN. Follow up was done at 2, 4, 6 weeks, 3 months, 6 months, and 1 year after the surgery. The patients were assessed functionally on the basis of Harris Hip Score and radiologically in the form of anteroposterior and lateral X-rays of the operated hip. The post-operative pain was also assessed as per the Harris Hip Score criteria at the end of 1 year and the post-operative gait was also assessed at the end of 1 year. Union was decided on the basis of obliteration of fracture line with bridging callus so as to allow unprotected function of the limb. Results: The results showed that the PFN group had significantly less operative time, intraoperative blood loss, and length of incision than the DHS group. No significant differences were found between the 2 groups regarding postoperative infection rate, lag screw cut-out rate, or reoperation rate. Conclusion: The current evidence indicates that PFN may be a better choice than DHS in the treatment of intertrochanteric fractures.