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April 1, 2018International Journal of Orthopaedics SciencesOpen Access

Prospective randomised control study of role of proximal femur nail and dynamic hip screw and plate in unstable intertrochanteric fractures of the femur in elderly

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Key result

Proximal femur nail (PFN) fixation resulted in significantly higher Harris Hip Scores at 1 month (33 vs 24.4, p<0.05) and fewer complications compared to dynamic hip screw (DHS).

Why the study?

Does proximal femur nail improve functional outcomes compared to dynamic hip screw in elderly patients with unstable intertrochanteric fractures?

Population

40 elderly patients with unstable intertrochanteric fractures of the femur

Comparison

Proximal femur nail (PFN) vs Dynamic hip screw (DHS)

Design

RCT, Randomized, divided equally into 2 groups of 20 each

Follow-up

1 month

Authors

NPNaveen PrKHKiran Kumar HGCPChaitanya Pr

Discussion

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Overview

PFN may be preferred over DHS for early recovery in elderly unstable intertrochanteric fractures; extends RCT evidence for intramedullary fixation.

Study Design

Type

RCT (n=40)

Randomization

computer generated random numbers

Multicenter

No

Structured PICO

Does proximal femur nail improve functional outcomes compared to dynamic hip screw in elderly patients with unstable intertrochanteric fractures?

P
Population
40 elderly patients (mean age 76.8 years, 56% female) with unstable intertrochanteric femur fractures were randomized to surgical treatment with either a proximal femur nail or dynamic hip screw.
I
Intervention
Proximal femur nail (PFN)
C
Comparator
Dynamic hip screw (DHS)
O
Outcome
Functional outcome evaluated based on Harris Hip Score (HHS)patient reported

Main Result

Absolute Event Rate: 33% vs 24.4%

p-value: p=<0.05

In elderly patients with unstable intertrochanteric fractures, proximal femur nail may yield better early functional scores at 1 month compared to dynamic hip screw.

Limitations

  • PFN has a slightly longer learning curve compared to DHS

Cite This Study

Pr et al. (2018) conducted an RCT in unstable intertrochanteric fractures of the femur (n=40). Proximal femur nail (PFN) vs. Dynamic hip screw (DHS) was evaluated on Harris Hip Score (HHS) at 1 month (p=<0.05). Proximal femur nail (PFN) fixation resulted in significantly higher Harris Hip Scores at 1 month (33 vs 24.4, p<0.05) and fewer complications compared to dynamic hip screw (DHS).

synapsesocial.com/papers/6ab9cd34fbf01674fdf0b133https://doi.org/10.22271/ortho.2018.v4.i2l.117
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparative study of functional outcome of the intertrochanteric fracture of femur managed by Dynamic hip screw and proximal femoral nail2019 · 14 citations
  2. 2Osteosynthesis of intertrochanteric fractures by PFN and DHS – A prospective randomized comparative study2020 · 10 citations
  3. 3Comparitive Study between Proximal Femoral Nailing and Dynamic Hip Screw in Intertrochanteric Fracture of Femur2013 · 32 citations
  4. 4Comparative evaluation of management of intertrochanteric fracture femur with proximal femoral nailing versus dynamic hip screw2020 · 1 citations
  5. 5Comparative study between proximal femoral nailing versus dynamic hip screw in unstable inter-trochanteric fractures of the femur in adults2021 · 5 citations