A prospective and comparative study of Cephalomedullary nailing over dynamic Hip screw in the management of intertrochanteric fracture

Abstract

Introduction: Intertrochanteric fracture is a leading cause of hospital admissions in elderly people. Conservative methods of treatment results in malunion with shortening and limitation of hip movement as well as complications of prolonged immobilization like bed sores, deep vein thrombosis and respiratory infections. Aims: To compare the results of surgical management of intertrochanteric fractures with Proximal Femoral Nail and Dynamic Hip Screw. Results: Out of 60 patients, there were 33 female and 27 male. Age group between 20-80. Most of the people were between 40-80 years. Slip and fall accounted for 70%of cases. Right side was more common, accounted for 56.66% of cases. Boyd and Griffin type II fracture accounted for 53.3% of cases. Mean duration of hospital stay was 26 days in both PFN and DHS groups. Mean time of full weight bearing was 10.6 weeks for PFN group and 14.8 weeks for DHS group. Out of 60 cases 4 cases died. Good to excellent results were seen in76.43% of cases in PFN group and 58.57% in DHS group. Conclusion: We consider PFN as better alternative to DHS in the treatment of intertrochanteric fractures but is technically difficult procedure and requires more expertise compared to DHS. With experience gained from each case operative time, radiation exposure, blood loss and intraoperative complications can be reduced in case of PFN.