Key result
Proximal Femoral Nail (PFN) yielded good to excellent functional results in 81.82% of patients compared to 53.85% with Dynamic Condylar Screw (DCS), with shorter hospital stays and faster union.
Why the study?
Treatment of subtrochanteric fractures remains challenging in orthopaedic trauma, especially in the geriatric population, prompting comparison of outcomes between PFN and DCS fixation.
Does Proximal Femoral Nail (PFN) improve clinical, functional, and radiological outcomes compared to Dynamic Condylar Screw (DCS) in patients with subtrochanteric femoral fractures?
RCT (n=35)
Randomized
No
Does Proximal Femoral Nail (PFN) improve clinical, functional, and radiological outcomes compared to Dynamic Condylar Screw (DCS) in patients with subtrochanteric femoral fractures?
Absolute Event Rate: 81.82% vs 53.85%
PFN offers advantages over DCS in terms of faster surgical procedure, less blood loss, shorter hospital stays, and faster union for subtrochanteric femoral fractures, although functional outcomes are comparable.
PFN may shorten hospital stay and union time versus DCS in subtrochanteric fractures; leaves open need for RCTs to confirm functional benefits.
Background: The treatment of Subtrochanteric fractures continues to be a challenge in orthopaedic trauma, especially in geriatric population. Among the various surgical technique- Proximal Femoral Nail (PFN) and Dynamic Condylar Screw (DCS) are the ideally sought implants for xation. Aims and objectives: This study was designed to assess the clinical, functional and radiological outcomes and complications of femoral subtrochanteric fractures treated with PFN and DCS Methodology: This is a prospective observational study of 35 cases of subtrochanteric femoral fractures admitted to KIMS hospital, Hubballi, Karnataka. These 35 cases then randomized into two groups of PFN and DCS. All patients were followed up with radiographs for every 4 weeks th for 3 months and on 6 month and outcome was assessed using modied Harris Hip Score. Results: In our study, mean duration of hospital stay was found to be 11.23 ± 3.038 days in PFN group and 14.08 ± 2.178 days in DCS group and mean time for union was 14.91 ± 3.006 weeks in PFN group and 17.33 ± 2.871 in DCS group. Good to excellent results were seen in 81.82% of subtrochanteric fractures in PFN group and 53.85% in DCS group. Conclusion: From this study, we conclude that, functionally there were no signicant difference between DCS and PFN but, PFN has advantages in terms of faster surgical procedure, less blood loss, shorter hospital stays and less time for union. However, in complex subtrochanteric fractures DCS denitely a reliable and a backup implant.
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Bhasme et al. (2022) conducted an RCT in Subtrochanteric femoral fractures (n=35). Proximal Femoral Nail (PFN) vs. Dynamic Condylar Screw (DCS) was evaluated on Good to excellent results (modified Harris Hip Score). Proximal Femoral Nail (PFN) yielded good to excellent functional results in 81.82% of patients compared to 53.85% with Dynamic Condylar Screw (DCS), with shorter hospital stays and faster union.
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