A study to compare the Functional, Clinical and Radiological outcome of Intertrochanteric fractures of femur in adult patients operated with Proximal Femoral Nail and Dynamic Hip Screw

Abstract

Background: Hip fractures a realeading source of illness and mortality in the elderly population, with a one-year mortality rate of up to 30%. The global yearly incidence of hip fractures is anticipated to be around 1.6 million, rising to 2.6 million by 2025 and 4.5 million by 2050 as the world's population ages. Objective: to compare the radiological and functional outcomes of Proximal femoral nail (PFN) and Dynamic hip screw (DHS) in the management of intertrochanteric fractures. Methods: This Prospective Observational Study was conducted Department of Orthopaedics, FH Medical College & Hospital, Agra, UP India.  All the patients attending Orthopaedics Emergency and OPD of FH Hospital during the period of study with trochanteric fractures above18 years of age of both sexes were included in the study. Duration of study was December 2020 to November 2022. Result: Forty patients treated with PFN and forty with DHS were included in the study. The PFN required shorter incision, less blood loss and operative time. The DHS required 16.25 seconds less fluoroscopy time. Patients treated with PFN had significantly better pain score at the 3 months and 6 months of follow up. Patient streated with DHS had more limb length shortening as compared to those treated with PFN. All the patient streated with PFN had comparatively better Harris hip score at subsequent follow ups.

Conclusion: The proximal femur nail offers as table fixation, minimizes the stress and allows early mobilization. It offers a superior stabilization than other currently used implants for such fracture.