A COMPARATIVE STUDY OF FUNCTIONAL OUTCOME FOLLOWING DYNAMIC HIP SCREW AND PROXIMAL FEMORAL NAILING FOR INTERTROCHANTERIC FRACTURES OF THE FEMUR

Abstract

Introduction: Inter-trochanteric fractures are common in the old age group. The goal/aim for the treatment for inter-trochanteric fractures will be to nearly restore pre-injury condition as early as it is possible. Dynamic hip-screw and proximal femoral-nailing has been the 2 standard treatment methods used for treating these kinds of fractures. The main goal of this proposed study was to compare functional outcomes of two available fixation devices for inter-trochanteric fracture using Harris Hip scoring. The to compare the functional outcome of the dynamic hip screw and proximal femoral nailing for the treatment of Intertrochanteric hip fractures achieved by the patient based on Harris hip score. Methods and materials: The clinical methodology for the study consists of 46 cases of Inter-trochanteric fractures of femur that meet the inclusion criteria of patients aged above 45years diagnosed with closed intertrochanteric fracture that are less than 3 weeks duration who were able to walk prior to fracture and exclusion criteria, admitted to R L Jalappa Hospital, Tamaka, Kolar between November 2019 and November 2021. The patients were divided into 2 groups, group A treated with DHS and group B treated with PFN and followed up at 6 weeks, 12 weeks and 24weeks based on the functional outcome on 24th week using Harris-hip score. Results: A total 46 patients were included in the study. Mean Age in Group DHS was 61.09 ± 11.69 and in Group PFN was 65 ± 14.98. In Group of DHS, 9 out of 23patients were male and 14 out of 23patients were female patients. In Group of PFN, 12 out of 23patients were male and 11 out of 23patients were female. Mean 6 weeks score in Group DHS was 34.43 ± 3.23 out of 100 and in Group PFN was 34.35 ± 2.5 out of 100. Mean Harris Hip Score in xiv Group DHS was 84.3 ± 7.68 out of 100. Mean Harris Hip Score in Group PFN was 89.26 ± 6.53 out of 100. In Group DHS, 52.17% had Injury on Left Side and 47.83% had on Right Side. In Group PFN, 39.13% had Injury on Left Side and 60.87% had on Right Side.In Group DHS, Results were Excellent in 34.78%, (8 patients) Good in 43.48% (10 patients) Fair in 17.39% (4 patients out of 23 patients),Poor in 4.35% (1 patient). In Group PFN, Results were Excellent in 56.52% (13 patients) Good in 34.78%(8 patients) Fair in 8.70% and (2 patients). Conclusion: From the study it can be concluded that Proximal Femoral Nailing had better Outcome in Intertrochanteric fractures compared to DHS. Highest percentage of subjects in PFN group had Excellent to Good Outcome and none of them had poor outcome when compared to DHS group. PFN group had higher scores of Harris Hip score at 12 weeks, 24 weeks and at the end of follow-up.