A Comparative Study of Proximal Femoral Nailing Versus Dynamic Condylar Screw Device in Surgical Management of Intertrochanteric Fractures
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 5273-5280
AbstractBackground: Intertrochanteric fractures are one of the most prevalent injuries in the elderly, especially in women and those with osteoporosis. About 50% of intertrochanteric fractures are comminuted and unstable. Therefore, treatment is challenging. They were treated at our facility with either Dynamic Condylar Screw (DCS)fixation or Proximal Femoral Nailing (PFN). The investigation was carried out to determine which form of surgical fixing provides the best functional result.
Methods: This cross-sectional interventional study was conducted in the Department of Orthopedics, Kakatiya Medical College, and MGM Hospital, Warangal, Telangana State. Based on the inclusion and exclusion criteria n=40 cases of intertrochanteric fractures were included in the study. They were divided into two groups of n=20 each and all the intertrochanteric fractures were treated by early surgical fixation with dynamic condylar screw fixation and proximal femoral nailing.
Results: The duration of healing was 6 weeks in 36% of cases, 10 weeks in 80% of cases and by 14 weeks 92% of cases were found to be healed. In Dynamic condylar screw placement, 28% of cases showed healing at 6 weeks, 68 % of cases showed healing at the end of 10 weeks and 84% of cases showed healing at the end of 14 weeks. overall results of the study revealed 80% of cases in proximal femoral nails had excellent and good results and 10 % had fair and 10% were with poor results. Whereas in dynamic condylar screw cases excellent results were in 60% of cases and poor results in 10% of cases
Conclusion: Type-1 and type-2 intertrochanteric fractures had better outcomes as compared to type-3 and type-4 intertrochanteric fractures. Pain, limp, support, distance walked, sitting, public transport, walking stairs, putting foot ware, absence of deformity. All these scores were better in proximal femoral nailing at the end of 3 and 6 months follow up than dynamic condylar screw. The mean blood loss during surgery was less in PFN as compared to dynamic condylar screws.
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