Treatment of Intertrochanteric Fracture With Dynamic Hip Screw Versus Proximal Femoral Nail

Document Type : Original Article

Authors

1 Resident of orthopedic surgery, Zagzig general hospital, Zagazig, Egypt

2 Professor of orthopedic surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

3 Lecturer of orthopedic surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Abstract

Background: Intertrochanteric fractures are of the most common fractures encountered in orthopedic practice. Several devices have been developed to obtain accurate reduction and stable surgical fixation. Dynamic hip screw (DHS) and Proximal femoral nail (PFN) are the most commonly used. Aim of work: To compare the radiological and functional outcome between Dynamic hip screw (DHS) and Proximal femoral nail (PFN) in the treatment of patients with intertrochanteric fracture. Subjects and methods Our randomized control clinical trial was conducted upon patients suffering from intertrochanteric fracture femur presented to the emergency department (ED) of Zagazig university hospitals and Zagazig ministry of health hospitals in the period from February 2022 till November 2022. This study included 36 cases of intertrochanteric femur fracture. The patients were grouped into two equal groups of group A included 18 patients treared by DHS and group B included 18 patients fixed by PFN. All patients underwent a thorough preoperative evaluation. Intraoperative and postoperative complications were recorded. After discharge, regular follow-up was done. Finally functional outcome is calculated. Results: PFN was superior to DHS intra-operatively in terms of reduced blood loss due to a shorter incision and shorter surgical time. Compared to DHS patients, PFN postoperative patients had fewer complications. PFN also has better Functional Outcomes in patients with unstable intertrochanteric fracture as per the Harris hip scores. Conclusion: Both the PFN and DHS almost always produce functional results that are equivalent in stable trochanteric fractures. However, the PFN has much better results than DHS in unstable trochanteric fractures.

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Zagazig University Medical Journal

Articles in Press, Accepted Manuscript
Available Online from 29 October 2023

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