Key result
Dynamic hip screw fixation resulted in significantly better functional outcomes (mean Harris Hip Score 90.8 vs 83.3, p=0.0036) compared to proximal femur locking compression plate in patients with pertrochanteric fractures.
Why the study?
Dynamic hip screw remains the gold standard for intertrochanteric fractures, but outcomes compared with the newer proximal femoral locking compression plate needed evaluation.
Does proximal femoral locking compression plate improve functional outcomes compared to dynamic hip screw in patients with pertrochanteric fractures?
RCT (n=60)
Randomized
No
Does proximal femoral locking compression plate improve functional outcomes compared to dynamic hip screw in patients with pertrochanteric fractures?
Absolute Event Rate: 83.347% vs 90.803%
p-value: p=0.0036
Dynamic hip screw remains the preferred implant for stable pertrochanteric fractures due to shorter operative time, less blood loss, and better functional outcomes, while PF-LCP is a viable alternative for unstable fractures.
I'll look up the trial so the implication matches the actual population and primary endpoint.Prefer DHS over PF-LCP for pertrochanteric fractures; confirms sliding-hip-screw standard care and challenges locking-plate first-line use.
Background: Pertrochanteric fracture is common in elderly people. Dynamic hip screw is still considered the gold standard for treating intertrochantric fracture. Proximal femoral locking compression plate is newer device. The purpose of the study was to compare the outcome of surgical treatment of trochanteric fracture by dynamic hip screw and proximal femoral locking compression plate. Methods: We study 60 patient admitted and followed up at J.L.N. Medical College Ajmer from June 2016 to April 2018 for minimum 6 month or till the bony union. Every fracture classified according to AO classification and functional result will be assessed according to Harris hip score using unpaired t test. Results: The mean operative time and average intraoperative blood loss was more in PFLCP group when compared with DHS group it was statically significant. DHS group has marginally better functional result then PFLCP group. There was no difference in the radiological outcome between two group. Conclusions: DHS is best implant for stable intertrochantric fracture but PFLCP can also be good alternative for unstable IT femur fracture.
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Harshwardhan et al. (2019) conducted an RCT in Pertrochanteric fracture (n=60). Proximal femur locking compression plate (PF-LCP) vs. Dynamic hip screw (DHS) was evaluated on Functional outcome (Harris Hip Score) (p=0.0036). Dynamic hip screw fixation resulted in significantly better functional outcomes (mean Harris Hip Score 90.8 vs 83.3, p=0.0036) compared to proximal femur locking compression plate in patients with pertrochanteric fractures.
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