Proximal femoral nailing is better choice in treatment of intertrochanteric fracture in elderly people

Abstract

Background: Intertrochanteric fractures are fractures involving proximal end of femur through and in between both trochanters with or without extension into upper femoral shaft. The aim of this study was to compare the results of proximal femoral nail (PFN) and dynamic hip screw (DHS) in treatment of intertrochanteric fractures.

Methods: 63 patients were treated by a dynamic hip screw (DHS) and proximal femoral nail in Service of Trauma in Regional Hospital Durres during 2012-2014. Patients were operated under X-ray intensifier control. Functional outcome, duration of operation, blood loss were studied and statistically evaluated for both of groups.

Results:The average age of our patient is 77.3 (57-95) years. 15/48: male/female. Fractures were classified under AO, 23.8% A1, 58.7% A2 and 17.5% A3. The average operating time for the patients treated with PFN was 49.3 min as compared to 72.3 min in patients treated with DHS. The average of intraoperatory blood loss was respectively 85.4 and 122.2 ml in PFN and DHS group. The patients treated with PFN had better Harris Hip Score in the early period (at 1^st and 3^rd month) and earlier ambulation, but in the long term (at 6^th and 12^th months) both the implants had the same functional outcomes.

Conclusions:The current evidence indicates that PFN may be a better choice than DHS in the treatment of intertrochanteric fractures.