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KMID : 0386720070190010036
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Journal of the Korean Hip Society
2007 Volume.19 No. 1 p.36 ~ p.44
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Treatment of Unstable Intertrochanteric Fractures: A Comparison of Proximal Femoral Nail and Dynamic Hip Screw
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Im Gun-Il
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Abstract
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Purpose: To retrospectively analyze and compare the results of proximal femoral nail (PFN) and dynamic hip screw (DHS) in the treatment of A22, 23 AO/OTA intertrochanteric fractures.
Materials and methods: Out of 100 patients who had an A22,23 unstable intertrochantericfractures, 50 patients were treated with DHS (Group I) and 50 patients were treated with PFN (Group II). The age, gender, preoperative morbidity, intraoperative data (type of anesthesia, duration of surgery, the amount of blood transfusion, the position of implant) and postoperative functional status and complications of both groups were compared.
Results: The mean surgical duration was shorter in the PFN group than in the DHS group (P=0.03) but the amount of transfusion was comparable. The intraoperative complications encountered were a femoral shaft fracture in the PFN group, cut-through of the lag screws in one patient from each group, and a loss of reduction in one hip in the DHS group. There were no significant differences in the union time, postoperative morbidity or mortality. The mobility score was higher in the PFN group than in the DHS group (P=0.02) even though the social function score was similar.
Conclusion: The use of PFN has the advantage of a shorter operative time and a better mobility of patients without altering the overall course of patients` recovery.
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KEYWORD
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Intertrochanteric fracture, Proximal Femoral Nail, Dynamic Hip Screw
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