Key result
Proximal femoral nailing and dynamic hip screw resulted in comparable functional outcomes at 6 months for intertrochanteric femur fractures, with no significant difference in mean Harris hip scores.
Why the study?
Does proximal femoral nailing improve functional outcomes compared to dynamic hip screw in patients with intertrochanteric fracture femur?
RCT (n=50)
Randomized
No
Does proximal femoral nailing improve functional outcomes compared to dynamic hip screw in patients with intertrochanteric fracture femur?
Both proximal femoral nailing and dynamic hip screw provide comparable functional outcomes for the treatment of intertrochanteric femur fractures at 6 months.
Answers are grounded in this paper and cite their sources.
Either PFN or DHS yields comparable functional recovery; confirms equivalence for intertrochanteric fracture fixation.
Background: Fractures involving trochanteric region of femur are one of the common fractures affecting elderly population. Presently surgical treatment is the treatment of choice with early mobilisation as primary goal. The two most common implants that are used are Dynamic hip screw (DHS) and Proximal femoral nail (PFN). Methods: This was a prospective study with 50 patients divided randomly into two groups of 25 each. One group operated by PFN and other with DHS. Patients were evaluated periodically and final comparison between two group was done at six months for analysing results on the basis of Harris hip score. Results: At final follow up in patients in PFN group 9 (36%), 7 (28%), 5 (20%), 4 (16%) patients had functional grade in excellent, good, fair and poor category respectively. In DHS group patients, 7 (28%), 10 (40%), 6 (24%), 2 (8%) patients had functional grade in excellent, good, fair and poor functional grade. Harris hip score was insignificantly (p>0.05) lower in patients of PFN (82.68±12.28) than DHS (84.60±10.39). Conclusion: At final follow up we found that pain, limp, use of support while walking and hospital stay was less in PFN group. However, range of motion and hip functions were better in patients treated with DHS. Complications like Varus malunion and infection were common in DHS group while hip joint stiffness was seen more commonly in PFN group. So, both PFN and DHS in are comparable in respect to most of functional criteria for treatment of intertrochanteric fracture femur.
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Adhikari et al. (2020) conducted an RCT in Intertrochanteric fracture femur (n=50). Proximal femoral nailing (PFN) vs. Dynamic hip screw (DHS) was evaluated on Harris hip score at 6 months (p=>0.05). Proximal femoral nailing and dynamic hip screw resulted in comparable functional outcomes at 6 months for intertrochanteric femur fractures, with no significant difference in mean Harris hip scores.
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