A prospective comparative study of basicervical fracture neck of femur with proximal femoral nail versus dynamic hip screw with derotation screw

Background: Basicervical femur fractures represent an intermediate between femoral neck and the intertrochanteric region. Fractures in this region have greater biomechanical instability due to their greater fracture angle, varus collapse, and are rotationally unstable. Aims and Objectives: The study was designed to evaluate and compare the functional outcomes, union rates, and radiological results of basicervical femoral neck fractures (BFNFs) treated using proximal femoral nail (PFN) compared to dynamic hip screw (DHS) with derotation screw (DRS) in patients aged 18 years and older. Materials and Methods: A simple randomized controlled trial was conducted on 30 patients with basicervical fractures admitted to Chigateri General Hospital and Bapuji Hospital attached to JJM Medical College, Davangere. All the patients underwent either PFN or DHS-DRS procedure as per the protocol. Results: The majority of patients were aged between 61 and 70 years. Males accounted for 60% in the PFN group and 53.3% in the DHS-DRS group. The average surgical duration was shorter in the PFN group (76.07±8.12 min) compared to the DHS-DRS group (103.5±5.70 min). At the 12-month follow-up, the modified Harris hip score was higher in the PFN group (90.03±4.14) than in the DHS-DRS group (80.23±2.11). After 1 year, 80% of PFN cases demonstrated excellent functional outcomes, in contrast to 40% in the DHS-DRS group. Conclusion: PFN technique may offer better surgical efficiency, reduced blood loss, improved functional recovery, and fewer complications compared to the DHS with DRS technique for the management of BFNFs.