Study of proximal femoral nail v/s dynamic hip screw in inter-trochantric fractures treated at Pravara Rural Hospital, Loni, Maharashtra, India
Journal Title: Medpulse International Journal of Orthopedics - Year 2018, Vol 7, Issue 3
Abstract
Background: This is the commonest injury seen in patients above 50 yrs of age, with more incidences in women. Multiple factors like aging, osteoporosis, anatomy of inter trochatric region, predispose to this type of injury. Many techniques were tried since 19th century, but only Dynamic Hip Screw (DHS) and Proximal Femoral Nail (PFN) have survived over so many years, and have been accepted by the surgeons and still today, these 2 modalities remain to be the treatment of choice in inter-trochantric fractures. Methods: A comparative study was carried out in sample size of 50 patients, wherein 25 patients were treated with DHS and other 25 treated with PFN during the period of September 2015 to September 2017 in Department of Orthopaedics, Rural Medical College, Loni, Maharashtra. Isolated intertochantric fractures with recent history, both stable and unstable were included in this study, while pathological fractures, paediatric fractures, polytrauma were excluded from this study. Results: Both the techniques were compared on various parameters like pain, fracture union, implant cut out, failure of implants, operative blood loss, duration of surgery, high risk cases, early weight bearing. On all these counts, this study revealed that although the difference was marginal, PFN was better technique over DHS especially in unstable fractures. Healing of fracture and weight bearing was found to be earlier with PFN than with DHS. Since the fracture hematoma is not opened in PFN, it allows biological healing of fracture. Conclusion: It was found that PFN is stronger construct to withstand cyclical loading and unloading in trochantric region. PFN was found to be better in high risk cases.
Authors and Affiliations
Dinesh Dhaytadak, Sanjay Mulay
Keywords
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