Key result
Proximal femoral nail fixation resulted in significantly higher Palmer and Parker mobility scores at six months compared to dynamic hip screw fixation (5.8 vs 4.19, p<0.001).
Why the study?
Does proximal femoral interlocking nail improve functional recovery and reduce complications compared to dynamic hip screw in patients with intertrochanteric femur fracture?
Cohort (n=92)
No
Does proximal femoral interlocking nail improve functional recovery and reduce complications compared to dynamic hip screw in patients with intertrochanteric femur fracture?
Proximal femoral nail allows faster mobilization and greater mobility scores at six months compared to dynamic hip screw for intertrochanteric femur fractures, with fewer wound infections.
Background: The aim of the present study was to compare the result in terms of rate of union, time of ambulation and functional recovery of fracture intertrochanteric femur treated by dynamic hip screw (DHS) and proximal femoral interlocking nail (PFN) and to compare complications in terms of implant failure, infection, blood loss and C arm exposure in both groups. Methods: This was a prospective study of 92 cases, 38 cases were treated by PFN and 54 cases were treated by DHS. Patients were followed up at 6, 12, 18 and 24 weeks. The results were compared for functional outcome using Palmer and Parker score and also for various complications. Results: Comparison of mobility score at six month follow up period revealed the PFN group to be significantly more mobile (5.8 Vs. 4.19 respectively, p <0.001) than the DHS group. In our study 6 patients managed with DHS (6.52%) developed superficial wound infection which responded to intravenous antibiotics. No patient with PFN had wound infection. Only 2 patients in the PFN group and 12 patients in the DHS group had persistent pain at the incision site. Conclusions: Dynamic hip screw fixation of these fracture requires less preoperative time, is associated with less exposure to radiation but the blood loss is much higher. On the contrary PFN allows faster mobilization and greater mobility scores at six months.
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Yadav et al. (2016) conducted a cohort in Intertrochanteric femur fracture (n=92). Proximal femoral nail (PFN) vs. Dynamic hip screw (DHS) was evaluated on Palmer and Parker mobility score at six months (p=<0.001). Proximal femoral nail fixation resulted in significantly higher Palmer and Parker mobility scores at six months compared to dynamic hip screw fixation (5.8 vs 4.19, p<0.001).
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