Treatment of stable intertrochanteric fractures of the femur with proximal femoral nail versus dynamic hip screw: a comparative study

• Autor(es): Sharma,Anmol ; Sethi,Anisha ; Sharma,Shardaindu
• Data: 2018
• Origem: Oasisbr
• Assunto(s): Bone nails; Bone screws; Fracture fixation, intramedullary/instrumentation; Hip fractures/surgery
• Tipo de Documento: Artigo científico
• Idioma: Inglês

Descrição

ABSTRACT Objective: To evaluate and compare the clinical and radiological outcomes of patients with stable intertrochanteric fractures treated with proximal femoral nail vs. dynamic hip screw. Methods: Sixty patients with stable intertrochanteric fractures, aged over 18 years, were randomly divided into the proximal femoral nail and dynamic hip screw groups. Dynamic hip screw with a three-hole side-plate and an anti-rotation screw were used, as well as a modified ultra-short proximal femoral nail for the smaller Asian population. The intra-operative, early and late complications were recorded, and the functional outcome of each group was assessed using the Harris Hip Score. Results: In the dynamic hip screw group, the one-month mean Harris Hip Score was slightly lower than that of the proximal femoral nail group. However, at the three- and six-month monthly follow-ups, the dynamic hip screw group presented higher mean scores than the proximal femoral nail group; at the one-year follow-up, both the groups attained similar scores. Conclusion: Proximal femoral nail provides a significantly shorter surgery with a smaller incision that leads to less wound-related complications. However, the incidence of technical errors was significantly higher in proximal femoral nail when compared with dynamic hip screw as it is a technically more demanding surgery that leads to more implant failures and the consequent re-operations.