Dynamic Hip Screw Versus Proximal Femoral Nail for Treatment of Trochanteric Hip Fractures: an Outcome Analysis with a Minimum 2 years of Follow Up
Keywords:
PFN, DHS, Proximal Femoral Nail, Dynamic Hip Screw, Intertrochanteric fractureAbstract
Introduction: during last 6 years study of intertrochanteric fracture femur was carried out at department of orthopaedics, DVVPF’s Medical College & Hospital. Total 155 patients were treated with PFN and DHS., 103 patient were PFN and 52 were DHS. Study Design: intertrochanteric fracture femur patient were surgically treated with PFN and DHS with plate. Total no. of 155 patients were operated under C-arm control and spinal or epidural anaesthesia. 103 were treated with PFN and 52 patient treated with DHS plate. PFN 72 were right side and 31 were left side, 62 were male & 41 were females, average age was 62 years. DHS were 52 patients, of which 30 were male, 22 were females, right side were 25 & left side 27, average age was 55 years. Aim: to compare the procedure during operative intervention and postoperative follow up for 2-3years. Comparison were made on the following points: 1) intra-operative time, 2) intra-operative blood loss, 3) post-operative mobilization, 4) post-operative electrolyte imbalance and disorientation, 5) healing and wight bearing, 6) implant cut through and failure, 7) limb length deficit and deformity, 8) failed procedure and 9) Infection. Results: results of PFN were superior to DHS. PFN was found more useful for osteoporotic & A2, A3 fracture types. Conclusion: PFN is preferable to DHS in the treatment of intertrochanteric fractures of femur.
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Adams CI, Robinson CM, Court- Brown CM, McQueen MM; Prospective randomized controlled trial of an intramedullary nail versus dynamic screw and plate for intertrochanteric fractures of the femur; J Ortho Trauma: 2001: 15:394-400
Boldin C, Seibert FJ, Fankhauser F, Peicha G, Grechenig W, Szyszkowitz R : The proximal femoral nail (PFN) – a minimal invasive treatment of unstable proximal femoral fractures : a prospective study of 55 patients with a follow- up of 15 months: Acta Orthop Scand: 2003; 74;53-58
Parker MJ, Pryor GA: Gamma versus DHS nailing for extra capsular femoral fractures; Meta-analysis of ten randomized trials: Int Orthop: 1996; 20: 163-168
Gundle R Gargan MF, Simpson AH: How tominimize failures of fixation of unstable intertrochanteric fractures : Injury: 1995; 26:611-614
Harrington P Nihal A. Singhania AK, Howell FR: Intra- medullary hip screw versus sliding hip screw for unstable intertrochanteric femoral fractures in the elderly : Injury : 2002; 33: 23- 28
Osnes EK, Lofthus CM, Falch JA, Meyer HE, Stensvold I, Kristiansen IS, Nordsletten L: More postoperative femoral fractures with the Gramma nail than the sliding screw plate in the treatment of trochanteric fractures: ACTA Orthop Scand: 200; 72: 252-256
Butt MS, Krikler SJ, NaWe S, Ali MS: Comparison of dynamic hip screw and gamma nail: a prospective randomized, controlled trial injury: 1995; 26:615-618
Banan H, Al – Sabti A, Jimulia T, Hart AJ : The treatment of unstable, extra capsular hip fractures with the AO/ ASIF Proximal femoral nail (PFN) – our Worst 60 cases: Injury : 2002; 33:401-405
Simmermacher RK, Bosch AM, Van der Weren C: The AO/ASIF - proximal femoral nail (PFN) :a new device for the treatment of unstable proximal femoral fractures : injury : 1999 ; 30: 327- 332
Sadowski C, Lubbeke A, Saudan M Riand N, Stern R, HoVmeyer P: treatment of reverse oblique and transverse intertrochanteric fractures with use of an intramedullary nail or a 95 degrees screw – plate: a prospective randomized study : J Bone Joint Surg Am; 2002; 84A : 372- 381
Zou J, Xu Y, Yang H: A comparison of proximal femoral nail antirotation and dynamic hip screw devices in trochanteric fractures : J Int Med Res: 2009; 37;1057- 1064
Marsh JL, Slongo TF, Agel J, Brodrick JS, Creevey W, DeCoster TA Prokuski L, Sirkin MS Ziran B, Henley B, Audige L: Fractures and dislocation classiWcation compendium – 2007: Orthopaedic Trauma Association classification, database and outcomes committee: J Orthop Trauma : 2007; 21; S1- S133
Liu Y, Tao Liu F,Wang Zhou Z Cao Y, Wang H: Mid –term outcomes after intramedullary fixation of peri – trochanteric femoral fractures using the new proximal femoral nail anti – rotation (PFNA). Injury: 2010; 41:810 -817
Regazzoni P, Ruedi T. Winquist R, Allgower M: the dynamic hip screw implant system. Springer, Berlin:1986
Vidyadhara S, Rao SK: One and two femoral neck screw with intramedullary nails for unstable trochanteric fractures of femur in the elderly – randomized clinical trial: Injury : 2007; 38 : 806- 814
Haidukewych GJ. Israel TA. Berry DJ. Reverse obliquity fractures of the intertrochanteric region of the femur: J Bone Joint Surg Am: 2007; 83- A643- 650
Hardy DC, Descamps PY, Krallis P, Fabeck L, Smets P, Bertens Cl, Delince Pe: Use of an intramedullary hip – screw compared with a compression hip- screw with a plate for intertrochanteric femoral fractures. A prospective, randomized study of one Hundred patients : J Bone Joint Surg Am: 1998; 80:618-630
Domingo LJ, Cecilia D, Herrera A, Resines C: Trochanteric fractures treated with a proximal femoral nail: Int Orthop : 2001; 25:298-301
Xu YZ, Geng DC, Mao HQ, Zhu XS, Yang Hl: A comparison of the proximal femoral nail anti-rotation device and dynamic hip screw in the treatment of unstable per-trochanteric fracture: J Int Med Res: 2010;38:1266-1275
Bellabarba C, Herscovici D Jr, Ricci WM: Percutaneous treatment of peri- trochanteric fractures using the Gamma nail : Clin Orthop Relat Res : 2000; 375:30-42
Mereddy P, Kamath S, Ramkrishan M, Malik H, Donnachie N: The AO/ASIF proximal femoral nail antirotation (PFNA) a new design for the treatment of unstable proximal femoral fractures: injury :2009, 40:428-432
Uzun M. Erturer E, Ozturk I. Akman S, Seckin F, Ozcelik IB: Long- term radiographic complications following treatment of unstable intertrochanteric femoral fractures with the proximal femoral nail and effects on functional results. Acta Orthop Traumatol Turc: 2009;43:457- 463
Yaozeng X, Dechun G, Huilin Y, Guangming Z, Xianbin W: Comparative Study of trochanteric fracture treaded with the proximal femoral nail antirotation and the third generation of gamma nail: injury : 2010; 41:986-990
Mehta M Strube P Peters A, Perka C, Hutmacher D, Fratzl P. Duda GN: Influences of age and mechanical stability on volume, microstructure, and mineralization of the fracture callus during bone healing : Is osteoclast activity the key to age- related impaired healing : Bone :2010;47:219-228
Liu M, Yang Z, Pei F Huang F,Chen S,Xiang Z:A meta – analysis of the Gamma nail and dynamic hip screw in treating peri- trochanteric ftracures: Int Orthop :2009 34:323-328
Forganolo F, Kfuri M Jr, Paccola CA: Intramedullary fixation of per-trochanteric hip fractures with the short AO-ASIF proximal femoral nail: Arch Orthop Trauma Surg:2004;124:31-37
Saudan M, Lubbeke A Sadowski C, Riand N, Sterm R, HoV meyer P: Per-trochanteric fractures : is there an advantage to an intramedullary nail?: a randomized, prospective study of 206 patients comparing the dynamic hip screw and proximal femoral nail: J Orthop Trauma :2002;16:386-393
Baumgaertner MR,Curtin SL, Lindskog DM: intramedullary versus Extra medullary fixation for the treatment of intertrochanteric hip fractures. Clin Orthop Relat Res: 1998;348:87-94
Min WK. Kim SY Kim TK, Lee KB, Cho MR, Ha YC, Koo KH: Proximal femoral nail for the treatment of reverse obliquity intertrochanteric fractures compared with gamma nail: J Trauma :2007; 63:1054-1060
Park SY, Yang KH, Yoo JH, Yoon HK, Park HW: The treatment of reverse obliquity intertrochanteric fractures with the intramedullary hip nail: J Trauma :2008;65:852-857
Willoughby R: Dynamic hip screw in the management reverses obliquity intertrochanteric neck of femur fractures: injury : 2005; 36:105-109
Babst R, Renner N, Biedermann M, Rosso R, Heberer M, Harder F, Regazzoni P: Clinical results using the trochanter stabilizing plate (TSP): the modular extension of the dynamic hip screw (DHS) for internal fixation of selected unstable intertrochanteric fractures : J Orthop Trauma: 1998; 12:392-399
Madsen JE, Naess L,Aune AK, Alho A, Ekeland A, Stromsoe K :Dynamic hip screw with trochanteric stabilizing plate in the treatment of unstable proximal femoral fractures: a comparative study with the Gamma nail and compression hip screw : J Orthop Trauma : 1998; 12:241-248.
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