Dynamic Hip Screw versus Proximal Femoral Nail in the Treatment of Stable Intertrochanteric Fractures
Creators
- 1. Associate Professor, Tezpur Medical College and Hospital, Assam
- 2. Assistant Professor, Tezpur Medical College and Hospital, Assam
- 3. Postgraduate Trainee, Tezpur Medical College and Hospital, Assam
Description
Background: The choice between dynamic hip screw (DHS) and proximal femoral nail (PFN) for the treatment of stable intertrochanteric fractures of hip remains controversial. This study aimed to compare the outcomes of these two implants in terms of early mobility, complications and functional recovery. Methods: A retrospective comparative study was conducted on 100 patients with stable intertrochanteric fractures (AO/OTA 31-A1) treated with either DHS (n=50) or PFN (n=50). Intraoperative, postoperative, radiographic, and functional outcomes were assessed. The minimum follow-up period was 12 months. Results: The PFN group had significantly shorter surgical times (55.2 ± 10.8 min vs. 68.4 ± 12.5 min, p<0.001), less blood loss (135.4 ± 38.7 mL vs. 180.6 ± 45.3 mL, p<0.001), earlier mobility (2.5 ± 0.9 days vs. 3.8 ± 1.2 days, p<0.001), better weight-bearing status at discharge (full: 48% vs. 20%, p=0.002), and shorter hospital stays (6.8 ± 1.9 days vs. 8.5 ± 2.3 days, p<0.001) compared to the DHS group. At 12 months, the PFN group had higher Harris Hip Scores (87.2 ± 5.9 vs. 84.6 ± 6.8, p=0.042) and Parker Mobility Scores (7.8 ± 1.3 vs. 7.2 ± 1.5, p=0.033). Complication rates were lower in the PFN group, but the differences were not statistically significant. Conclusion: PFN may be associated with better outcomes compared to DHS in the treatment of stable intertrochanteric fractures, particularly in terms of early rehabilitation and long-term functional recovery. Larger prospective studies are needed to confirm these findings.
Abstract (English)
Background: The choice between dynamic hip screw (DHS) and proximal femoral nail (PFN) for the treatment of stable intertrochanteric fractures of hip remains controversial. This study aimed to compare the outcomes of these two implants in terms of early mobility, complications and functional recovery. Methods: A retrospective comparative study was conducted on 100 patients with stable intertrochanteric fractures (AO/OTA 31-A1) treated with either DHS (n=50) or PFN (n=50). Intraoperative, postoperative, radiographic, and functional outcomes were assessed. The minimum follow-up period was 12 months. Results: The PFN group had significantly shorter surgical times (55.2 ± 10.8 min vs. 68.4 ± 12.5 min, p<0.001), less blood loss (135.4 ± 38.7 mL vs. 180.6 ± 45.3 mL, p<0.001), earlier mobility (2.5 ± 0.9 days vs. 3.8 ± 1.2 days, p<0.001), better weight-bearing status at discharge (full: 48% vs. 20%, p=0.002), and shorter hospital stays (6.8 ± 1.9 days vs. 8.5 ± 2.3 days, p<0.001) compared to the DHS group. At 12 months, the PFN group had higher Harris Hip Scores (87.2 ± 5.9 vs. 84.6 ± 6.8, p=0.042) and Parker Mobility Scores (7.8 ± 1.3 vs. 7.2 ± 1.5, p=0.033). Complication rates were lower in the PFN group, but the differences were not statistically significant. Conclusion: PFN may be associated with better outcomes compared to DHS in the treatment of stable intertrochanteric fractures, particularly in terms of early rehabilitation and long-term functional recovery. Larger prospective studies are needed to confirm these findings.
Files
IJPCR,Vol16,Issue7,Article145.pdf
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Additional details
Dates
- Accepted
-
2024-06-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue7,Article145.pdf
- Development Status
- Active
References
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