Muhammad Zafar Iqbal Shahid, Tanveer Haider, Usman Ali, Maqsood Akhtar, Faizan Majeed.
Comparison of surgical outcome of intertrochanteric fracture of femur with proximal femoral nail (PFN) versus dynamic hip screw (DHS).
J Allama Iqbal Med Coll Jan ;19(4):977-82.

Background: Intertrochanteric fractures account for more than half of the hip fractures out of which 50% of these fractures are unstable. Proximal femoral fractures incidence has increased in the presence of osteoporosis and rise in life expectancy in elderly people while road traffic accidents are the leading cause in young people. Objective: To compare and evaluate the surgical outcomes of proximal femoral nail and Dynamic Hip Screw in unstable intertrochanteric fractures of femur. Methods: This prospective comparative study was conducted from January, 2018 to January, 2020. A total no. of 60 patients with unstable type II intertrochanteric fractures was included in the study. These were divided in two equal groups. Each group had 30 patients. The approval for the study was obtained from the Hospital ethical and review board. Before the procedure, each patient was counseled regarding the procedure and a written consent was obtained from each patient. Each patient was followed at weekly interval up to 6 weeks and then at 3rd, 6th and 12th month. Each patient was assessed both clinically and radiologically. Functional assessment was done with Harris Hip Score. In group A we performed PFN and in group B we performed DHS. Results: Age range in our study was 25-70 years (average 62 years). In group A there were 20 males and 10 females, while in group B there were 25 males and 5 females. Most of the fractures were as a result of Road traffic accident (46 patients) while in 14 patients it was as a result of slip and fall. Size of incision duration of surgery, blood loss and return to pre injury status was much less in patients where PFN was done as compared to DHS. Moreover Harris hip score was better in patients where PFN was done and these patients started early weight bearing as compared to patients where DHS was done. Conclusion: It was concluded from the study that PFN is better implant for unstable intertrochanteric fractures than DHS. It results in less blood loss and reduced duration of surgery. There was reduced hospital duration and early weight bearing in case of PFN. Moreover the complications rate was also less. Keywords: Proximal Femoral Nail (PFN), Dynamic Hip Screw (DHS), Intertrochanteric Fractures, Unstable intertrochanteric fractures, Harris Hip Score

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