scholarly journals Antirotation proximal femoral nail versus dynamic hip screw for intertrochanteric fractures: A meta-analysis of randomized controlled studies

2013 ◽  
Vol 99 (4) ◽  
pp. 377-383 ◽  
Author(s):  
L. Shen ◽  
Y. Zhang ◽  
Y. Shen ◽  
Z. Cui
2015 ◽  
Vol 2 ◽  
pp. 73-80
Author(s):  
Yong-tao Zhang ◽  
Jing Niu ◽  
Xin-zhi Chen ◽  
Zai-jie Tian ◽  
Guo-yong Qiao ◽  
...  

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Xiao Huang ◽  
Frankie Leung ◽  
Zhou Xiang ◽  
Pei-Yong Tan ◽  
Jing Yang ◽  
...  

Background. The purpose of this meta-analysis was to find out whether the proximal femoral nail was better than the dynamic hip screw in the treatment of trochanteric fractures with respect to operation time, blood transfusion, hospital stay, wound complications, number of reoperation, and mortality rate.Methods. All randomized controlled trials comparing proximal femoral nail and dynamic hip screw in the treatment of trochanteric fractures were included. Articles and conference data were extracted by two authors independently. Data was analyzed using RevMan 5.1 version. Eight trials involving 1348 fractures were retrieved.Results. Compared with DHS fixation, PFN fixation had similar operation time (95% CI: −15.28–2.40,P=0.15). Blood loss and transfusion during perioperative time were also comparable between the two fixations (95% CI: −301.39–28.11,P=0.10; 95% CI: −356.02–107.20,P=0.29, resp.). Outcomes of hospital stay (95% CI: −0.62–1.01,P=0.64), wound complication (95% CI: 0.66–1.67,P=0.82), mortality (95% CI: 0.83–1.30,P=0.72), and reoperation (95% CI: 0.61–1.54,P=0.90) were all similar between the two groups.Conclusion. PFN fixation shows the same effectiveness as DHS fixation in the parameters measured.


Author(s):  
E. S. Radhe Shyam ◽  
K. Ashwin

<p class="abstract"><strong>Background:</strong> The incidence of inter trochanteric fracture is expected to have doubled by 2040. Inter trochanteric fractures account for about 45% to 50% of all hip fractures in the elderly populationand out of these, near about 50% to 60% are classified as unstable intertrochanteric fractures. The goal of treatment is restoring mobility safely and efficiently, while minimizing the risk of medical complications and technical failure. This study as performed<strong> </strong>to assess functional outcome with dynamic hip screw and proximal femoral nail in intertrochanteric fracture management.</p><p class="abstract"><strong>Methods:</strong> It was prospective observational study done for a period of 1year from January 2016-January 2017 among patients who attended OPD or emergency department with intertrochanteric fracture. Two different implants were used dynamic hip screw (DHS) and proximal femoral nail (PFN).<strong></strong></p><p class="abstract"><strong>Results:</strong> Excellent results in functional outcome was more in case of PFN (66.6%) compared to DHS (50%). The type of trauma in DHS group was road traffic accident in 38.8%, domestic fall in 50% and others such as assault was in 11.1% while in PFN group intertrochanteric fracture was seen in 61.1% due to domestic fall.</p><p class="abstract"><strong>Conclusions:</strong> The functional outcome was more better with proximal femoral nail (PFN) compared to dynamic hip screw (DHS). Therefore, proximal femoral nail (PFN) should be preferred for management of intertrochanteric fractures.</p>


2021 ◽  
Vol 8 (26) ◽  
pp. 2271-2277
Author(s):  
Gajanand Shriram Dhaked ◽  
Abhishek Komalsingh Jaroli ◽  
Khushboo Parmanand Malav ◽  
Harish Narayan Singh Rajpurohit

BACKGROUND Current management of Intertrochanteric (IT) fractures has evolved with the introduction of dynamic hip screw (DHS) and proximal femoral nail (PFN). The purpose of this study was to compare the functional outcomes between the DHS and PFN for IT fracture fixation. METHODS This study is a retrospective comparative analysis of 455 patients with IT fractures; DHS (292) and PFN (163), who were treated from June 2012 to June 2015. The patients were reviewed postoperatively for a minimum of 12 months to evaluate functional outcome using Salvati-Wilson score. Categorical data was present as absolute number or percentages, and parametric variables were presented as Mean ± SD, while non parametric data were presented as median. Statistical significance was defined as P < 0.05. RESULTS Intramedullary nails offer no advantage over extramedullary devices to treat IT fractures caused by low-energy trauma (AO 31 - A1). However, clinically significant outcomes were established for PFN group in terms of duration of surgery, x- ray exposure and SW Score for AO / OTA 31 - A2 and 31 - A3. Reoperations encountered for local pain due to implant prominence were significantly higher in the PFN group (4.90 % versus 1.02 %). Kaplan Meier survival probability of 69.3 % and 79.5 % predicted for DHS and PFN respectively, 3 years postoperatively. CONCLUSIONS Our conclusion reinforces indication for PFN in unstable IT fractures (31 - A2 and 31 - A3), owing to its better functional outcome and biomechanical properties. Functional outcomes for stable IT fracture (AO 31 - A1) were comparable between DHS and PFN, therefore final decision for implant choice depends on implant cost, surgeon’s preference for specific technique. However, understanding the morphology of proximal femur, peritrochanteric region is crucial to analyse the anatomical variations in Indian population which will provide the basis for intramedullary nail design modifications. KEYWORDS Intertrochanteric Fractures, DHS Fixation, PFN Fixation


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