Evaluation of the results of intertrochanteric femur fractures fixation by dynamic hip screw versus gamma nail

Abstract

Background: Femoral intertrochanteric fractures account for approximately half the hip fractures in elderly patients. The aim of this study is to evaluate the results of the treatment of intertrochanteric fractures in adults using Dynamic Hip Screw (DHS) and Gamma nail (GN) and evaluate radiologically the effect of these implants on normal proximal femoral morphology.Methods: This prospective randomized study was carried out on 40 patients ranged from 18 to70 years old (20 patients were managed by Dynamic Hip Screw (DHS) and 20 patients were managed by GN). Patients were subjected to: history taking, physical examination, mechanism of trauma, the harris hip score (HHS), radiographic evaluation.Results: There was significant difference regarding operative time, number of gauzes soaked with blood, number of C-arm shots and follow up time and insignificant difference Regarding gender, age or occupation, comorbid diseases and mechanism of injury or side of lesion, HHS score, postoperative complications, and postoperative changes of proximal femur, Conclusions: In femur fractures fixation, DHS and GN are useful in the treatment of trochanteric femoral fractures, although the results were slightly in favor of DHS fixation (in stable fractures), GN has shorter operative duration, less blood loss, earlier weight bearing despite of higher number of C-arm shots needed.