A comparative study of proximal femoral nail and dynamic hip screw for intertrochanteric fractures of the femur

Abstract

Intertrochanteric fracture is one of the most common fractures of the hip. However, the implant of choice for type II intertrochanteric fracture is still under debate. The aim of this study was to compare the functional outcomes of proximal femoral nail (PFN) and dynamic hip screw (DHS) in treatment of intertrochanteric fractures. We did a prospective comparative study on 60 patients of type II intertrochanteric fractures operated with closed/open reduction and internal fixation with either DHS or PFN between October 2018 and March 2023. During each follow-up, the functional outcome of patients was calculated using the Harris hip score. There was a statistically significant difference present in average functional scores between the two groups at 1 month, 3 months and 6 months; however, no difference was seen at the end of 12th month follow-up. Functional outcomes in the DHS group were excellent in 34.78%, fair in 17.39%, good in 43.48% and poor in 4.35%. In the PFN group, results were excellent in 56.52%, fair in 8.70% and good in 34.78% and no poor results were seen. In stable two-part intertrochanteric femur fractures, both PFN and DHS are equally effective but due to minimal invasiveness. PFN is a better implant of choice than DHS in the treatment of elderly patients with intertrochanteric fractures.