EFFECT OF FEMORAL NECK LENGTH RESTORATION ON FUNCTIONAL OUTCOMES OF PATIENTS WITH INTERTROCHANTERIC FRACTURES: A COMPARISON BETWEEN DYNAMIC HIP SCREW AND PROXIMAL FEMUR NAIL

S Gavhale; E Pawar; V Shet; H Dave; G Aher; A Amin; J Manna

Volume : IX, Issue : VI, June - 2020

EFFECT OF FEMORAL NECK LENGTH RESTORATION ON FUNCTIONAL OUTCOMES OF PATIENTS WITH INTERTROCHANTERIC FRACTURES: A COMPARISON BETWEEN DYNAMIC HIP SCREW AND PROXIMAL FEMUR NAIL

S Gavhale, E Pawar, V Shet, H Dave, G Aher, A Amin, J Manna

Abstract :

Intertrochanteric fracture occurring in osteopenic bone is the most common type of proximal femur fracture in old age. Neck length collapse is associated with improper fixation leading to shortening and impaired abduction mechanism. We followed up a cohort of 206 patients for a period of 4 years. The patients were classified into two groups, Dynamic Hip Screw (DHS) and with Proximal Femoral nailing (PFN) techniques. Harris Hip Score and sequential radiographs were used to compare functional outcome and degree of femoral neck collapse respectively between groups. DHS group had a higher degree of Moderate (24.04%) as well as Severe (18.27%) collapse as compared to the PFN group which had a 18.62% of Moderate and a 6.86% of Severe collapse. Using Harris Hip Score, higher percentage of Excellent outcomes (58.82%) were observed in PFN group compared to DHS group (11.54%). Our findings indicate that the PFN is a superior implant than DHS as far as restoring the femoral neck length is concerned and correspondingly provide much better functional outcomes. This also shows that restoring femoral neck length is in general associated with better functional outcomes in patients suffering from intertrochanteric fracture