Management of Pertrochanteric Fractures with Proximal Femoral Nail and Comparison of Results with Dynamic Hip Screw

Introduction: Proximal Femoral Nail and Dynamic Hip Screw, both are the accepted implants for the internal fixation of Pertrochanteric fractures. Objectives of the research were to compare the results of proximal femoral nail and dynamic hip screw in terms of functional mobility of the patients and the results would also be compared in terms of operating time, peri-operative blood loss, radiological exposure, time to mobilize with frame, wound infection and implant failure. Material and Methods: A Randomized prospective study was conducted in the outdoor and emergency facilities of department of orthopaedics in a level II hospital. Patients who sustained closed fracture and are beyond 40 years of age were included in the study. Eligible candidates were admitted and randomized to group ‘A’ or ‘B’. Group ‘A’ patients were managed by Proximal Femoral Nail and group ‘B’ were managed by Dynamic Hip Screw. Parker and Palmer mobility score before trauma and after 6 month follow-up period was noted. Results: A total number of 61 patients were randomized to either PFN group (n=25) or DHS group (n=36). Our analysis shows that PFN group patients were significantly more mobile than DHS group patients in terms of P and P score at 6 month follow up ( 5.8 for PFN Vs 4.19 for DHS, p<0.001). The patients with unstable fracture benefited greatly with PFN by gaining higher P and P score over DHS group (5.46 for PFN Vs 3.50 for DHS, p<0.001). Conclusion: Proximal femoral nail gives early and greater extent of mobility to the patients.