Comparative Study of Management and Clinical Outcome of Intramedullary Versus Extramedullary Fixation for Unstable Intertrochanteric Fractures

Introduction: Surgery is the common therapy for intertrochanteric fractures as this fracture takes a long time to heal on its own. Open reduction and internal xation (ORIF) is one of the surgical treatments for this fracture (4). Based on the location and type of the fracture different kinds of xation devices are used. However, the best repairing method for intertrochanteric fractures is still controversial. To Evaluate Aim And Objective: functional outcome and Compare the result of treatment with intramedullary (PFN) versus extramedullary (DHS and PFLCP) xation for unstable intertrochantric fracture. In this prospective study from March 2018 to October 2019, 40 conse Methodology: cutive patients with unstable intertrochanteric femoral fractures having an unstable pattern, of either sex were randomized by computer generated tables to undergo xation with either Intramedullary and extramedullary xation.A detailed history and clinical examination was done in a systemic manner and noted on a specially designed proforma. Plain radiographs were obtained on admission and all fractures categorized according to AO/ASIF. In Result: intramedullary group the mean blood loss was 142.5 ml whereas in DHS group it was 330 ml and PFLCP group it was 415 ml. In intramedullary group 5% subjects had wound infection, In DHS group 10% subjects each had malunion, wound infection and screw cutout, whereas in PFLCP group 2(20%) subjects each had wound infection and screw cutout. in unstable intertrochante Conclusion: ric fractures, the intramedullary xation has signicantly better outcome in terms of early restoration of walking ability, shorter operative time, a smaller incision and less blood loss during surgery as compare to extramedullary xation of unstable intertrochanteric fractures.