A COMPARATIVE STUDY OF PROXIMAL FEMORAL NAILING VERSUS DYNAMIC HIP SCREW IN SURGICAL MANAGEMENT OF INTERTROCHANTERIC FRACTURES CONDUCTED AT ONE OF THE TERTIARY CARE HOSPITALS IN LUCKNOW

Abstract

Introduction: Proximal femoral Fractures are a subset of fractures that occur in the hip region and occupy large proportion of hospitalization amongst trauma cases.An overwhelming majority of these patients (>90%) are aged above 50 years. These are classified on the basis of anatomic location for example, femur neck fracture; inter trochanteric fracture and subtrochanteric fracture.Therefore,the aim of the present study was to achieve fracture union by using two different kinds of internal fixation modality devices in similar type of fractures. Material and Methods: This is a randomized prospective study of 40 cases of intertrochanteric fractures,admitted to Career Institute of Medical Science, Lucknow.All fractures were classified by the Seinsheimer classification system.The patients were treated with proximal femoral nailing (PFN) and/or dynamic hip screw (DHS) and were categorised randomly into two groups, each of 20 patients, 20 were treated by dynamic hip screw and 20 were treated with proximal femoral nail (PFN). Results: The intraoperative parameters were in favour of PFN with significantly less duration of surgery,length of incision and blood loss but more fluoroscopy time.Postoperatively also,PFN group patients excelled with significantly less post-operative pain, less incidence of deep infection, less mean limb length discrepancy and more patients regaining their pre injury walking capability with also fewer complications. Conclusion: PFN emerged to be superior to DHS in unstable intertrochanteric fractures.Intramedullary implants have been quite effective in sub-trochanteric fractures and should be preferred better than extra-medullary plate fixation systems.