COMPARATIVE EVALUATION OF FUNCTIONAL OUTCOME OF USE OF PROXIMAL FEMORAL NAIL VERSUS DYNAMIC HIP SCREW IN THE MANAGEMENT OF PERTROCHANTERIC FRACTURE.

Dr Sunil Malhotra, Dr Salil kumar Gupta, Dr (Prof) Kamal Swarn, Dr (Prof) Avinash Rastogi

Abstract


Introduction

Pertrochanteric fractures are becoming increasingly common as our population ages. These fractures typically occur in elderly patients and often result in the end of the patient's functional independence .Conservative methods of treatment for pertrochanteric fractures have shown higher morbidity and complications rates . Rigid internal fixation and early mobilisation has become standard method of treatment for such fracture . A variety of treatment options have evolved like extra medullary implants (Fixed angle plates or D.H.S.) and  intramedullary implants (P.F.N)  for pertrochanteric fractures .There are numerous literature advocating for both the procedure citing their advantage of one over another. The present study was done with comparative evaluation of functional outcome of use of proximal femoral nail versus dynamic hip screw in the management of pertrochanteric fracture to determine whether there is advantage advantage of one method over other or not.

 

Material and Method

This  prospective study was conducted in Netaji Subhas Chandra Bose Subharti Medical College from  June 2017 to September 2019. Total 60 patients  were included in this study in which 30 were included in  PFN group “P” and  30 in DHS group “D”. Intra-operative parameters like duration of surgery, length of incision, c-arm exposure , blood loss were evaluated and post-operatively patient was followed for minimum of 6 months and evaluation  was done by Harris hip score.

Results

PFN group had less blood loss, less length of incision, long duration of surgery, early union and fewer complication as compare to DHS group . Follow up of patients showed that Harris hip score at 24th week in PFN group was better than DHS group.

Conclusion

The present study demonstrates PFN group had better function outcome as compare to DHS group.


Keywords


Pertrochanteric fractures, PROXIMAL FEMORAL NAIL, DYNAMIC HIP SCREW

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References


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