Dynamic Hip Screw Versus Proximal Femoral Nail in the Treatment of Stable Intertrochanteric Fractures
Iraqi Postgraduate Medical Journal,
2016, Volume 15, Issue 4, Pages 406-412
Intertrochanteric fracture is a common injury among older age group , it occupy a high percentage of fragility fractures admitted to the casualty department , lots of methods have been used over decades. Dynamic hip screw (DHS) was the gold standard technique since its invention, however after introduction of the proximal femoral nail (PFN) to the markets in the 90s, this represented a major turning point in the management of intertrochanteric fracture especially the unstable ones.
To compare the results of DHS versus PFN in the management of stable intertrochanteric fractures.
PATIENTS AND METHODS:
Prospective study included 35 patients who underwent operation by either DHS or PFN, all patients sustained stable intertrochanteric fracture and operated within one week. Closed reduction was done in all patients, PFN cases were done through small incisions under fluoroscope guidance, while DHS cases were operated through standard lateral approach. Patients were assessed according to intraoperative parameters of blood loss, duration of surgery and postoperative parameters regarding partial and full weight bearing, amount of shortening in mm, rate of union, functional score using palmar and proud score , rate of infection and implant complication.
Significant differences were noted regarding blood loss and weight bearing in favor of PFN, while duration of surgery was less in DHS. No significant differences were noted regarding other parameters.
The study revealed significant difference in favor PFN regarding blood loss, weight bearing and shortening.
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