Management of intertrochanteric fractures by dynamic hip screw VS proximal femoral nail

Introduction: Inter trochanteric fractures are more common in the age group of 20 years to 60 years due to high velocity road traffic accidents, Whereas inter trochanteric fractures may also be seen in elderly people due to mild to moderate severity of trauma in addition to high velocity trauma. The management of stable intertrochanteric fractures in young and old individuals either by Dynamic Hip Screw (DHS) or by Proximal Femoral Nail (PFN) and management of unstable IT fractures by PFN in both the age groups young and old. Materials and Methods: The study is conducted in the department of orthopaedics at Shadan Institute of Medical Sciences (SIMS). A total no. of 43 patients are included in the study out of which 20 are stable fractures, remaining are unstable fractures. The mean age is 34 years (range 20-60 yrs). The mean follow up period is 34 months (12-36 months). Results: Out of 20 patients with stable fractures treated by DHS, 15 pts (%) are excellent outcome, 3pts (%) good, 2 pts (%) fair, poor result is nil. Out of 23 patients with unstable IT fractures treated by PFN, 18 pts (%) are excellent, 3 pts (%) good, 1 pt (%) fair & 1 pt (%) with poor result. Conclusion: All IT fractures which are stable in young and old patients can be treated either by DHS or PFN with satisfactory outcome and all unstable fractures in young and elderly people should be treated by PFN. Irrespective of type of fracture, fixed by PFN has got the advantage of early mobilisation and weight bearing.