Comparative study between proximal femoral nailing and dynamic hip screw in management of intertrochanteric fracture of femur

Abstract

The PFN required significantly shorter incisions, less blood loss and operative times. The DHS group required 16sec less fluoroscopy time. Post operative complication in both group included malunion and infection, 5 malunion in DHS while 1 in PFN, 2 wound infections in DHS while 1 in PFN and 1 screw back out in DHS. Patients treated with PFN had a significantly lower pain score at the sixth month of follow up. Patient treated with DHS had more limb length shortening as compared to those treated with PFN. The outcomes of the stable fractures treated with either DHS or PFN were similar. Unstable intertrochanteric fractures, treated with PFN, had significantly better outcomes with all patients having good results. Though both PFN and DHS have similar functional outcome in stable fracture and PFN has better function outcome with unstable fractures, PFN requires shorter operative time and a smaller incision, it has distinct advantages over DHS even in stable intertrochanteric fractures. Hence, in our opinion, PFN may be the better fixation device for most intertrochanteric fracture.