Key result
In 60 patients with intertrochanteric fractures, proximal femoral nail resulted in a significantly higher Harris Hip score at 9 months compared to Dynamic Hip Screws.
Why the study?
Although proximal femoral nails and dynamic hip screws are used for intertrochanteric fractures, existing results and conclusions regarding their outcomes remain inconsistent.
Does proximal femoral nail improve functional outcomes compared to dynamic hip screw in patients with intertrochanteric fractures?
RCT (n=60)
Randomized
No
Does proximal femoral nail improve functional outcomes compared to dynamic hip screw in patients with intertrochanteric fractures?
Proximal femoral nail provides better functional outcomes, less blood loss, shorter surgery duration, and smaller incisions compared to dynamic hip screws for intertrochanteric femur fractures.
PFN was associated with better functional scores and less blood loss than DHS; leaves open need for RCTs before changing practice.
Intertrochanteric fractures are among the most common hip fractures, particularly in the elderly with osteoporotic bones, and are typically caused by low-energy trauma such as simple falls. Although PFN and DHS have been used to treat intertrochanteric fractures, the results and conclusions are inconsistent. The present Prospective Comparative study was conducted at the Department of Orthopaedics, MSDASMC, Bahraich, over 24 months, from June 2019 to June 2021. Intertrochanteric fractures were treated randomly, whether using the Dynamic Hip Screws (DHS) or the proximal femoral nail (PFN). Out of a total of 60 cases, all of them were included. A group of 30 patients was separated into two groups: the first group received 30 Dynamic Hip Screws, while the second group had 30 PFN. Every patient was followed for nine months after their treatment. In our study, the mean Age in the PFN group was 62.5 ± 4.26, while in the DHS group, it was 63.7 ± 3.78 years. In the present study, a higher Harris Hip score (HHS) was observed in PFN groups. Their intergroup comparison of Harris Hip score between PFN and DHS group revealed significant differences at each follow-up. Furthermore, the minimal blood loss, duration of surgery, and incision size was low in the PFN group, and the difference was statistically significant compared to the DHS group. Mean hospital stay also showed no significant differences. In the intertrochanteric fracture of the femur, the PFN is a more suitable fixation approach. To the extent that it will further the generalizability and dependability of the research, the demand will be granted.
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Kumar et al. (2021) conducted an RCT in Intertrochanteric fractures of femur (n=60). Proximal femoral nail (PFN) vs. Dynamic Hip Screws (DHS) was evaluated on Harris Hip score (HHS). In 60 patients with intertrochanteric fractures, proximal femoral nail resulted in a significantly higher Harris Hip score at 9 months compared to Dynamic Hip Screws.
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