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ORIGINAL ARTICLE
Year : 2015  |  Volume : 4  |  Issue : 1  |  Page : 21-26

Comparison of outcome of management of unstable pertrochanteric femoral fractures with dynamic hip screw and proximal femoral nail


Department of Orthopaedics, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India

Correspondence Address:
Dr. Hemant Sharma
390, Shastri Nagar, Back Side Police Lines, Amritsar, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1597-1112.162236

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Context: Pertrochanteric fractures of the proximal femur are a common occurrence among elderly patients. The two types of implants most commonly used for internal fixation of these fractures are dynamic hip screw (DHS) and proximal femoral nail (PFN). However, limited data exist showing comparison between these implants for the treatment of unstable pertrochanteric fractures which are more difficult to manage than the stable ones. Aims: The purpose of this study was to compare the outcome of management between both implants in the treatment of pertrochanteric fractures. Settings and Design: It is a prospective study done at Sri Guru Ram Das Institute of Medical Sciences. Amritsar (Punjab), India. Materials and Methods: Totally, 30 cases of unstable pertrochanteric fractures (Arbeitsgemeinschaft für Osteosynthesefragen [AO] type 31A2 and 31A3) were included and treated using PFN and DHS (15 cases each) from July 2011 to June 2013. Alternate allocation to each implant group was done. Follow-up was for about 6 months. Results were obtained with regard to operation time, blood loss, fluoroscopy, time to union, time to full weight bearing, and the requirement for revision surgery. Functional scoring was done using the Salvati and Wilson hip score. Statistical Analysis Used: Clinical and radiological data were analyzed using the statistical software epi-info version 3.5.1 released in August 2008. Results: Patients who underwent fixation by PFN had a shorter operation time, lesser blood loss, and returned to full weight bearing earlier than those who had DHS. However, more fluoroscopic exposure was recorded in PFN than DHS. Time to union was more or less the same. Patients who underwent PFN fixation had better Salvati and Wilson hip scores than those with DHS. Conclusions: In unstable pertrochanteric fractures, PFN definitely holds an edge over DHS.


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