![]() ![]() half an hour before surgery.įracture Reduction: A closed reduction was then carried out by applying traction on fracture table and was confirmed in both A.P and Lat. Patients were given prophylactic dose of third generation cephalosporin and aminolycosides i.v. The other limb is placed in an attitude of extension and abduction. Great care is taken in padding the heels in the foot stirrups and the perineal region. The fracture table is essential to achieve reduction and as it allows free access for the C- arm in both views. Patient Positioning: All cases were operated on a standard fracture table. After all required investigations and physician and anaesthetic consultation patients were posted for surgery under regional anaesthesia. The overall time from injury to surgery averaged 3.2 days (range: 1-6 days). Selection of Treatment: The decision for the type of operation was based on surgeon’s preference and availability of the implant. Those unable to cooperate in postoperative period due to medical conditions.Patients with pathological fractures due to metastasis, tumors were excluded.Those who are unfit to surgery due to very high risk factors.Those who did not walk before the fracture.All patients above 60 years with intertrochanteric fractures were selected.Out of 208 patients, 108 were treated with Proximal Femoral Nail (P.F.N.) and 100 were treated by Dynamic Hip Screw and all patients were followed up for one year. The patients were divided into two groups. The study was a prospective study involving 208 patients of intertrochanteric fractures treated by operative management at Department of orthopedics, Government Medical College Miraj, from February 2014 to January 2016. Our study was aimed at comparing the proximal femoral nail (PFN) with the old method of dynamic hip screw with side plate (DHS) The total duration of surgery, blood loss, infection rate, wound complications, implant failure, post-operative function was to be compared between both devices. Was the Sliding hip screw with plate to be replaced with the intramedullary hip screw. It is now a debate started on which would be the best implant to fix IT fractures. The intramedullary device is a more biological method of fixation. 4,6 An intramedullary device bears the bending load which is transferred to the intramedullary nail and is resisted by its contact against the medullary canal. Theoretically intramedullary nail possesses certain advantages. 5 However, mechanical and technical failures continue to occur in as many as 6% to 18% of cases treated by a compression hip screw and side plate. It is currently considered the gold standard for fixation of IT fractures. The most commonly used implant is the dynamic hip screw (DHS) with side plate. Intramedullary implants (Gamma nail, P.F.N), Extramedullary implants (D.H.S), Arthroplasty (Bipolar hemiarthroplasty or T.H.R). Several fixation devices been developed to overcome difficulties encountered in the treatment of unstable intertrochanteric fractures. Any medical condition associated with bone loss, like diabetes mellitus, hyperparathyroidism, Hyperthyroidism and Cushing’s syndrome is associated with rise in the risk for hip fracture. Hagino et al 15 reported a lifetime risk of hip fracture for individuals at 50 yrs of age of 5.6% for men and 20.0% for women. of hip fractures worldwide will reach 2.6 million by 2025. Gullber 1 has predicted that the total no. Intertrochanteric fractures are commonly seen in elderly patients, mostly due to trivial trauma. Key Words: Proximal femoral nail (PFN), Dynamic hip screw (DHS), intertrochanteric fractures. Conclusion: The intramedullary device (PFN) is more useful in the treatment of unstable intertrochanteric fractures as compared to extramedullary device (DHS). There were no significant difference in functional outcome between both groups. The overall complication rate is less in intramedullary PFN group. Results: The intramedullary group required lesser operative time (p = <0.05) and associated with lesser blood loss (p= <0.05) than the extra medullary group. Also assessment of functional outcome was made. All relevant pre and perioperative information and complications were recorded. Total 108 patients of PFN group and 100 patients in DHS group were studied. Method: It is prospective selective comparative study of an intramedullary device (PFN) group compared with extramedullary DHS group. Vikas R Rokade 1*, Pankaj Lawate 2, Emmanuel Bhore 3ġ Associate Professor, 2Resident, 3Assistant Professor, Department of Orthopedics, Government Medical College, Miraj, Maharashtra, INDIA.Įmail: Objective: To compare functional outcome and complications associated with PFN an intramedullary device with DHS an extramedullary traditional device. Comparison between Dyanamic hip screw with side plate (DHS) and proximal femoral nail (PFN) in intertrochanteric fractures of femur: A prospective clinical study ![]()
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