A comparative study of proximal femoral fracture fixation with proximal femoral nail and Dynamic hip screw & plating

Introduction: Trochanteric fractures are one of the commonest injuries sustained predominantly in patients over sixty years of age. They are three to four times more common in women than in men. These usually occur through bone affected by osteoporosis; trivial fall being the most common mechanism of injury [1]. Discussion: The goal of this study was to compare the functional outcomes of patients with intertrochanteric fractures treated by two different fixation devices, the extramedullary dynamic hip screw and the intramedullary proximal femoral nail. Our study consisted of 30 patients with 30 intertrochanteric fractures out of which 15 were treated with DHS and 15 with PFN. Conclusion: We conclude that in stable intertrochanteric fractures, both the PFN and DHS have similar outcomes. However, in unstable intertrochanteric fractures the PFN has significantly better outcomes in terms of earlier restoration of walking ability as it is an intramedullary implant which can tolerate higher cylindrical loading when compared to DHS type of implants. Bibliography 1. Kaufer H. Mechanics of the Treatment of Hip Injuries. Clin Orthop. 1980; 146:53-61. 2. Kyle RF, Gustilo RB, Premer RF. Analysis of six hundred and twenty-two intertrochanteric hip fractures. A retrospective and prospective study. J Bone Joint Surg. 1979; 61A:216-21. 3. Kaufer H, Mathews LS, Sonstegard D. Stable Fixation of Intertrochanteric Fractures. J Bone Joint Surg. 1974; 56A:899-907. 4. Jewett EL. One-piece angle nail for trochanteric fractures. J Bone Joint Surg. 1941; 23:803-10. Larsson S, Elloy M, Hansson LI. Stability of Osteosynthesis in Trochanteric Fractures. Comparison of three fixation devices in cadavers. Acta Orthop Scand. 1988; 59:386-90.