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Category: Volume 07 Issue 06 June 2019
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Title: A Prospective comparative study of dynamic hip screw and proximal femoral nail for trochanteric fracture femur

Authors: Dr Vijendra Damor, Dr Sachin Upadhyay, Dr Sudheer Rawat

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.31

Abstract

      

Aim and Objective: To compare the functional outcome of proximal femoral nailing and dynamic hip screw in inter-trochanteric fracture femur.

Material and Method: This prospective analytic study was conducted at the Department of Orthopedics and Traumatology NSCB MCH Jabalpur between 2011 to 2015. Total 64 Cases were selected by inclusion and exclusion criteria. Out of 64 cases, 30 cases were treated with PFN and 34 with DHS. All the operations were done under image intensifier control. Follow up of the patients were done up to 48th postoperative weeks for the assessment of functional and anatomical outcome.

Observation and Result: Present series is of 64 cases with average age of 50-70 years out of which 43.75% were male and 56.25% were female. Most common mode of injury was trivial injury/minor slip comprising 65.62% patients. Second commonest mode of injury was Road Traffic accident comprising 26.56%. The fracture was classified by EVAN’S classification, 65.62% cases were of stable fracture, 34.3% of unstable type. Fracture were reduced under image intensifier and fixed with D.H.S or P.F.N. By 3rd postoperative weeks, in PFN group 91.66% of cases were partial weight bearing with crutches, But in DHS group by 6th postoperative weeks 75% of cases partial weight bearing with help of crutches, full weight bearing in P.F.N group was 10.6 wk and in D.H.S group it was 14.8 wk.IN PFN group 6.66% and in DHS group 17.76% were having superficial infection, while 11.5% in D.H.S group had deep infection, no deep infection in P.F.N group.

Conclusion: In PFN group patients, blood loss and soft tissue dissection was less as compared to DHS group patients. Within first 3 months PFN allowed a faster postoperative restoration of walking ability as compared to DHS. It was found that there was no major difference between PFN and DHS treatment group long term follow-up in clinical and radiological features.

Keyword:  Proximal Femoral Nail, Dynamic Hip screw, Inter trochanteric fracture femur.

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Corresponding Author

Dr Sudhir Rawat

58 Bapu Nagar, Near Ratlam Public School, Ratlam, M.P, India