Key result
Proximal femoral nailing is associated with better functional outcomes vs dynamic hip screw with stabilization plate.
Why the study?
Conservative management of intertrochanteric fractures often results in malunion with coxa vara deformity, prompting surgical fixation to reduce morbidity and mortality.
Does proximal femoral nailing improve functional outcomes and reduce blood loss compared to dynamic hip screw with trochanteric stabilization plate in patients with unstable intertrochanteric femur fractures?
Observational (n=50)
No
Does proximal femoral nailing improve functional outcomes and reduce blood loss compared to dynamic hip screw with trochanteric stabilization plate in patients with unstable intertrochanteric femur fractures?
Absolute Event Rate: 81.8% vs 79.28%
p-value: p=0.013
Intramedullary fixation with proximal femoral nailing provides better functional outcomes, less blood loss, and shorter operative time compared to extra medullary fixation for unstable intertrochanteric femur fractures.
May support proximal femoral nailing for better function; hypothesis-generating and requires randomized confirmation before practice change.
Context: Most frequent fractures of proximal femur are intertrochanteric fractures which involve upper end of femur between both trochanters with or without extending into the upper femoral shaft occuring commonly in geriatric patients. Unstable contribute to about 50%-60% of all intertrochanteric fractures. Aims: Though intertrochanteric fractures unite without surgical intervention, malunion with coxa vara deformity occur with conservative management. The aim of fixation of intertrochanteric fractures is to prevent morbidity and mortality. With this aim of stable surgical reconstruct of intertrochanteric fracture this study was done to evaluate functional, clinical and radiological outcome of unstable intertrochanteric fracture operated with dynamic hip screw with trochanteric stabilization plate (extra meduary fixation) and proximal femoral nailing (intramedullary fixation) and study epidemiology and demographics of intertrochanteric femur fractures in Indian scenario. Settings and Design: Methods and Material: The study was conducted at New Civil Hospital Surat. 50 patients with unstable intertrochanteric femur fractures admitted between february 2018 to march 2019. Conclusions: In this study we found that both-extra-medullary or intramedullary fixation were able to provide good clinical result for unstable Intertrochanteric femur fracture. We conclude that there is statistically significant difference between patients operated with DHS with TSP (Extra medullary implant) and Proximal Femoral Nail (Intramedullary implant) in terms of Blood loss, Mean operative time and functional outcome. Harris hip score in patients treated with PFN had better Harris hip score at final follow up which was statistically significant. All patients in both groups had bony union at final follow up. Blood loss and duration of surgery was significantly less with intramedullary Implant.
No takes yet. Share an insight, caveat, or question.
Menon et al. (2021) conducted an observational in Unstable intertrochanteric femur fractures (n=50). Proximal femoral nailing vs. Dynamic hip screw with trochanteric stabilization plate was evaluated on Functional outcome (Harris hip score) (p=0.013). Proximal femoral nailing resulted in significantly better functional outcomes (mean Harris hip score 81.8 vs 79.28, p=0.013) compared to dynamic hip screw with trochanteric stabilization plate.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: