Study of the functional outcome following surgical management of intertrochanteric fractures with either proximal femoral nailing or dynamic hip screw fixation

Abstract

Intertrochanteric fractures are one of the most common injuries sustained predominantly in patients over 60 years of age. They are 3 or 4 times more common in elderly women who are osteoporotic, in whom trivial trauma is the most common mode of injury. A total of 98 patients of intertrochanteric fractures of the femur were operated during this period in our institute. Among these patients, 26 patients died after surgery and did not follow up and were not included in this study. The rest of the patients were not traceable via telephone, some even by home visitations by us due to difficulty in tracing certain home addresses. Patients who were followed up for upto 6 months to 1 year were included in this study. All patients were in Sahlstrand’s Grade 1 walking ability before trauma. Post-op walking ability in this study shows 60%PFN patients walking without support with 33.3% DHS patients walking without support and 66.7% patients of DHS walking with cane and 13.3% patients of PFN needing 2 canes or walker post-operatively measured at 6 months post-op. It was found that proximal femoral nailing had better functional outcome in patients with especially unstable fractures and DHS had better functional outcome among the stable fractures.