Retrospective Comparative study of Dynamic Hip Screw Fixation and Proximal Femur Nailing in Osteoporotic Intertrochanteric Femur Fractures

BACKGROUND AND OBJECTIVES: Intertrochanteric fractures is one of the common most fractures of the hip especially in the older age groups with osteoporotic bones. Women are most susceptible and most common mode of injury is Trivial fall. The aim of management of an intertrochanteric fracture is the recovery of the patient back to optimal function and prevention of future hip fractures. This led to the fact that these fractures are fixed internally. The two types of implants used for internal fixation of these fractures are DHS and PFN. Intramedullary devices like the PFN has advantage in these fractures as their lie close to the mechanical axis of the limb, and hence the rate of implant failure is lesser. AIM OF THE STUDY: The purpose of the our study is to assess the advantages of proximal femoral nail in terms of fracture union, anatomical reduction and also the functional outcome compared to the patients treated with DHS. MATERIALS AND METHODS: This is a retrospective study of forty patients with intertrochanteric fracture (stable and unstable) who has radiological evidence of osteoporosis (Singh’s index) treated by PFN or DHS. The results are compared for functional outcome using Modified Harris Hip score RESULTS: Pain is significantly lesser in patients managed by PFN. The limb length discrepancies occurs at higher rate in the patients managed by DHS. In both stable and unstable intertrochanteric fractures, patients treated with PFN, had significantly better outcomes. CONCLUSION: From our study, we consider PFN as better alternative to DHS in treatment of intertrochanteric femur fractures