Comparing Clinical Results between Dynamic Hip Screw and Proximal Femoral Nail in Surgical Treatment of Unstable Intertrochanteric Femoral Fractures

Intertrocentric femoral fracture is the most common fracture and has the highest mortality rate after surgery. The main treatment for this type of fracture is surgery and the choice of appropriate surgical instrument plays a key role in reducing the incidence of complications. This study amed at comparing clinical outcomes between Dynamic Hip Screw (DHS) and Proximal Femoral Nail (PFN) in surgical treatment of unstable intertrochanteric fractures of the femur.

A cross-sectional study using causal-comparative design was conducted in all patients attending orthopedic clinic in Sari Imam Khomeini Hospital with intermittent femoral fractures who needed surgical treatment between 2012 and 2018. Thirty patients were randomly divided into two groups to be treated either by DHS or PFN implants. The two groups were compared for clinical results, including operation time and and anesthesia time, the need for blood transfusion during and after the surgery, cut out of the device, fracture fusion, and neck and emoral trunk angles. Data analysis was done in SPSS V21.

Findings showed no significant difference between DHS and PFN implantation in terms of fracture fusion (P= 0.234) and cut-out of the device after the surgery (P= 0.157). It was also found that DHS required less time for surgery and anesthesia (P= 0.012). Patients treated with DHS also required significantly less blood transfusion than those in PFN group (P= 0.02).  

In this study, treatment of unstable intertrochanteric fractures using DHS was found to be superior to PFN due to lower length of surgery and anesthesia, and lower need for blood transfusion.