Functional and radiological outcome of unstable intertrochanteric fractures treated by proximal femoral nail and dynamic hip screw

Introduction: Unstable intertrochanteric fractures are difficult to manage and the choice of implant is critical for fracture fixation. Operative management allows early rehabilitation and offers to the patient the best chances for functional recovery in trochanteric fractures. The purpose of this study is to compare the functional and radiological outcome of unstable intertrochanteric fractures treated with DHS and PFN. Materials and Method: 50 unstable Inter-trochanteric hip fractures that were surgically treated between November 2015 and June 2016 at our institution were included in study. 25 patients were treated with DHS fixation and 25 patients were treated with PFN fixation. All surgeries were done on traction table and are followed up at regular intervals of 6 weeks, 10 weeks, 4months, 6 months and annually thereafter. Results: The functional results are assessed with Harris Hip Score and we observed good or excellent results in 64% of DHS group and good or excellent results in 80% of PFN group. We observed no statistically significant difference between two groups in view of late & early complications and time to union. The mean follow up period was 13 months (range, 9 -16 months). Conclusions: We observed significantly better functional outcome in PFN group for unstable inter-trochanteric fractures. In unstable fractures we observed total duration of surgery, blood loss and image intensifier exposure time to be significantly lower in PFN group. We concluded that PFN may be the better fixation device for most unstable inter-trochanteric fractures.