Study Comparing the Advantages of Proximal Femoral Nail Over Dynamic Hip Screw Among Patients with Subtrochantric Fractures

Background: Subtrochanteric fractures are one of the common fractures encountered in today's orthopaedic practice. Choice of implant still remains with the surgeon. The advantages and disadvantages of the Gamma nail have been well established in several studies done in the past, usually by comparing the results with the Dynamic hip screw (DHS). This study deals with the comparison of Proximal femoral nailing (PFN) versus Dynamic hip screw (DHS) in treatment of subtrochanteric fractures. Methods: This study was conducted in M. S. Ramaiah Hospitals from October 2007 to August 2009. During this period 50 cases of adult patients with subtrochanteric fractures of femur were selected according to the inclusion criteria and classified according to Seinsheimer's classification. Results: We found that PFN was superior to DHS in many ways such as reduced intra-operative blood loss, lesser operative time, reduced radiation exposure, less amount of limb shortening, reduced hospital stay, lesser infection rates and early mobilization. Conclusion: Nailing has the advantage of providing rotational as well as axial stability in cases of subtrochantric fractures allowing a faster postoperative restoration of walking ability, when compared with the dynamic hip screw.