PFN v/s DHS in stabilization of intertrochanteric fractures: A comparative study

Background: Trochanteric fractures are the most common injuries predominantly in patients over sixty years of age because of trivial fall and osteoporotic nature of bones. The aim of the study is compare the functional outcome of inter trochnateric fractures treated with proximal femoral nail (PFN) and dynamic hip screw (DHS). Methods: The study was conducted on 40 cases of inter trochanteric fractures, 20 were treated with PFN and 20 were treated with DHS. Patients were operated on standard fracture table under image intensifier control. Results: Average age of patient was 62.6 years. 62.5% of the total patients were females. The most common mode of injury was trivial fall. There were 23 stable fractures and 17 unstable fractures. Mean Fluoroscopy time taken for PFN and DHS were 73.75 and 57.5 minutes respectively. The mean duration of surgery in the DHS and PFN were 91.25 and 68.25 minutes respectively. The DHS patients had significantly more blood loss (average 380ml) intraoperatively compared to PFN group (average 127.05ml). 3 patients (15 percent) in the DHS group had malunion whereas 1 patient (5 %) in the PFN group had malunion. 2 patients of the DHS group had wound infections as compared to single patient in the PFN group. The average range of motion the hip joint was 84.00 degree in the DHS group and 99.25 degree in the PFN group at 6 months of follow up.Conclusion: We conclude that in stable intertrochanteric fractures, both the PFN and DHS have similar outcomes. However, in unstable intertrochanteric fractures the PFN has significantly better outcomes.