Comparison of Proximal Femoral Nail and Dynamic Hip Screw in Intertrochanteric Fracture

Muhammad Siqaf Anjum; Aimal Sattar; Waheed Anwar; Syed Haseeb Ullah Shah; Aiman Usman Lodhi; Hamid Nawaz

doi:10.70749/ijbr.v3i3.2546

Authors

Muhammad Siqaf Anjum Department of Orthopedics, Lady Reading Hospital, Peshawar, KP, Pakistan.
Aimal Sattar Department of Orthopedics, Lady Reading Hospital, Peshawar, KP, Pakistan.
Waheed Anwar Department of Orthopedics, Lady Reading Hospital, Peshawar, KP, Pakistan.
Syed Haseeb Ullah Shah Department of Orthopedics, Lady Reading Hospital, Peshawar, KP, Pakistan.
Aiman Usman Lodhi Neurology Department, Hayatabad Medical Complex, Peshawar, KP, Pakistan.
Hamid Nawaz Department of Orthopedics, Lady Reading Hospital, Peshawar, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i3.2546

Keywords:

Femur Intertrochanteric Fractures, Dynamic Hip Screw, Proximal Femoral Nail.

Abstract

Background: Femur intertrochanteric fractures are the most frequent hip fractures. Its frequency is increasing as a result of the growing elderly population. Objective: Comparison of the outcomes of dynamic Hip Screw and proximal femoral nail in intertrochanteric fracture. Material and method: The present randomized control trail was carried out at the Department of Orthopedics Lady Reading Hospital Peshawar over a period of 6 months from July 2024 to January 2025 after taking approval from the research committee of the hospital. Individuals with femur intertrochanteric fractures (ASA class l/II of both genders and different age group (ranged 30-70 years) were included in this study. Non-probability consecutive sampling technique was used for collection of sample and sample size was determined through Open Epi sample size calculator. The sample size determined was 470 individuals. The study participants were equally divided in to group A (DHS) and B (PFN). Both groups had same number of individuals. In group A individuals underwent a standard lateral approach to the proximal femur while positioned supine on a fracture table. In group B, patients underwent a standard lateral approach to the proximal femur while lying supine on a fracture table. Following surgery, all patients were given injectable antibiotics, oral antibiotics till the sutures were taken out, and an intravenous cephalosporin for five days. On the second or third postoperative day, static quadriceps strengthening activities were initiated. The last follow-up and Harris hip score (HHS) evaluation was done six months later. All the data was analyzed using SPSS version 26. Results: A total of 470 individuals were enrolled in this study and were divided in to group A and B and each group had same number of individuals. Group A had received dynamic hip screw while group B underwent proximal femoral nail for the management of intertrochanteric femoral fractures. The mean age of the individuals in group A was 38.28±25.88 years and in group B was 44.73±15.25 years. When compared to DHS Group-A, the PFN Group-B demonstrated noticeably less blood loss (p-value<0.001) and operational time (p-value<0.001). Conclusion: The present study concluded that proximal femoral nail is a much better alternative than dynamic Hip Screw for treating femur intertrochanteric fractures.

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