A comparative study of fixation of Unstable intertrochanteric Fractures of femur in elderly with dynamic hip screw and proximal femoral nail

Volume 16 | Issue 2 | April-June 2021 | Page 2-5 | Eknath D Pawar, Akshay KS, Devanshu Gupta, Amit Kumar Yadav, Sagar Bansal, Angad Ravindra Chikodi


Authors: Eknath D Pawar [1], Akshay KS [1], Devanshu Gupta [1], Amit Kumar Yadav [1], Sagar Bansal [1], Angad Ravindra Chikodi [1]

[1] Department of Orthopaedics, Grant Govt Medical College & Sir JJ Group of Hospitals Mumbai, India

Address of Correspondence

Dr. Akshay KS,
Department of Orthopaedics, Grant Govt Medical College & Sir JJ Group of
Hospitals Mumbai, India
E-mail: akshayks700@gmail.com


Abstract

Introduction: Intertrochanteric femur fractures are a common entity in the elderly population and most of them occur following trivial trauma. The incidence of these fractures worldwide is on the rise owing to the increased life expectancy and osteoporosis. The optimal treatment of unstable fractures especially in severely osteoporotic patients remains controversial. Poor bone quality, excessive collapse, metal failure, loss of fixation, and cut-out of the lag screw are the common problems encountered during the attempts to fix these fractures. However, the advantage of Proximal Femur Nailing fixation is that it provides a more biomechanically stable construct by reducing the distance between hip joint and implant.
Objective: The purpose of our study was to compare the results of Proximal femur nail [PFN] and dynamic hip screw [DHS] for unstable intertrochanteric fractures of elderly in terms of functional outcome and complications.
Methods: From 2017-2019, 100 patients were enrolled in the study as per the inclusion criteria and results were analysed prospectively. According to AO Classification, type 3A2.2 and 3A2.3 and above were included. 60 were operated with Short PFN and 40 with Dynamic hip screw. Patients were followed up at regular intervals of 4 weeks, 8 weeks, 12 weeks, 6 months and annually thereafter. The functional results were assessed with Harris Hip Score. Results: 37.5% excellent results in DHS group and 66.2% excellent results in PFN group were obtained. We observed statistically significant difference between two groups in view of functional outcomes, complications and time to union. Total duration of surgery was significantly lower in PFN group
Conclusion: For severe osteoporotic elderly with unstable fractures, Short PFN is an effective surgical method compared to DHS to reduce the complications and improve the functional outcome. The procedure offers the best chance to the patient for faster mobilization, improves the quality of life and gives a long-term solution.
Keywords: Intertrochanteric fractures, femur, dynamic, proximal femoral.


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How to Cite this article: Pawar ED, Akshay KS, Gupta D, Yadav AK, Bansal S, Chikodi AR. A comparative study of fixation of Unstable intertrochanteric Fractures of femur in elderly with dynamic hip screw and proximal femoral nail. Journal of Trauma and Orthopaedic Surgery April-June 2021;16(2): 2-5.

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