Assessment of the Proximal Femoral Nailing and Dynamic Hip Screws in Intertrochanteric Fractures

Femoral Nailing and Hip Screws

Authors

  • Muhammad Rizwan Ali Department of Orthopedics Unit 2, Jinnah Hospital, Allama Iqbal Medical College, Lahore, Pakistan
  • Irfan Ahmad Department of Orthopedics Unit 2, Jinnah Hospital, Allama Iqbal Medical College, Lahore, Pakistan
  • Nauman Naeem Ahmed Department of Orthopedics Unit 2, Jinnah Hospital, Allama Iqbal Medical College, Lahore, Pakistan
  • Muhammad Farhan Shahzad Department of Orthopedics Unit 2, Jinnah Hospital, Allama Iqbal Medical College, Lahore, Pakistan
  • Yasir Umer Ali Medical Centre, Islamabad, Pakistan
  • . Lavisha College of Physiotherapy, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
  • Shafqat Shahzad College of Statistical and Actuarial Sciences, University of the Punjab, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i10.1892

Keywords:

Intertrochanteric Fracture, Proximal Femoral Nailing, Dynamic Hip Screw, Femur Fracture Management, Orthopedic Surgery

Abstract

An intertrochanteric fracture is one of three types of proximal femur fractures, occurring in the proximal part of the femur. The other two types are subtrochanteric fractures, which occur below the trochanters, and proximal (or cephalad) fractures of the femoral neck. Objective: To assess the differences in hospital stay, blood loss, and operative time between proximal femoral nailing and dynamic hip screws in the management of intertrochanteric fractures of the femur. Methods: Quasi-experimental study was conducted in Unit II of the Orthopedic Surgery department at Jinnah Hospital Lahore. It included eighty patients whose demographic profiles (name, age, gender, and BMI) were collected. Using a non-probability consecutive sampling technique, patients were divided into two groups: Group A underwent Dynamic Hip Screw (DHS) surgery, while Group B received Proximal Femoral Nailing (PFN) surgery. Data on operative time, blood loss, and hospital stay were analyzed using SPSS version 21.0, with outcomes compared via independent sample t-test at p < 0.05 significance. Results: Regarding hospital stay, blood loss, and operating time, DHS and PFN differed significantly. Compared to the DHS group, the PFN group's operating time, blood loss, and length of hospital stay were much lower. Conclusion: This study has demonstrated that PFN is a far superior option to DHS for treating femur intertrochanteric fractures. Going forward, suggested PFN rather than DHS for femur fractures of this kind.

References

Chang SM, Hou ZY, Hu SJ, Du SC. Intertrochanteric femur fracture treatment in Asia: what we know and what the world can learn. Orthopedic Clinics. 2020 Apr; 51(2): 189-205. doi: 1016/j.ocl.2019.11.011.

Davis TR, Sher JL, Horsman A, Simpson M, Porter BB, Checketts RG. Intertrochanteric femoral fractures. Mechanical failure after internal fixation. The Journal of Bone and Joint Surgery British Volume. 1990 Jan; 72(1): 26-31. doi: 10.1302/0301-620X.72B1.2298790.

Haidukewych GJ. Intertrochanteric fractures: ten tips to improve results. The Journal of Bone and Joint Surgery. 2009 Mar; 91(3): 712-9.

Muazzam MA and Ali A. Prevalence of Intertrochanteric Fractures in Young Population with Hip Fractures Presented in Ghurki Trust Teaching Hospital Lahore. Pakistan Journal of Medical and Health Sciences. 2022 Aug; 16(06): 727-. doi: 10.53350/pjmhs22166727.

Martinho T and Stoffel K. Treatment of intertrochanteric femur fractures with hip arthroplasty in older patients: a narrative review of indications and outcomes. Medicina. 2021 Jul; 57(8): 763. doi: 10.3390/medicina57080763.

Kumar P, Rajnish RK, Sharma S, Dhillon MS. Proximal femoral nailing is superior to hemiarthroplasty in AO/OTA A2 and A3 intertrochanteric femur fractures in the elderly: a systematic literature review and meta-analysis. International Orthopaedics. 2020 Apr; 44: 623-33. doi: 10.1007/s00264-019-04351-9.

Sadeghi C, Prentice HA, Okike KM, Paxton EW. Treatment of intertrochanteric femur fractures with long versus short cephalomedullary nails. The Permanente Journal. 2020; 24. doi: 10.7812/TPP/19.229.

Yıldırım C, Muratoğlu OG, Turan K, Ergün T, Mısır A, Aydın M. The intra-and interobserver reliability of five commonly used intertrochanteric femur fracture classification systems. Joint Diseases and Related Surgery. 2022 Apr; 33(1): 187. doi: 10.52312/jdrs.2022.498.

Mallya S, Kamath SU, Annappa R, Nazareth NE, Kamath K, Tyagi P. The Results of Unstable Intertrochanteric Femur Fracture Treated with Proximal Femoral Nail Antirotation‐2 with respect to Different Greater Trochanteric Entry Points. Advances in Orthopedics. 2020 Mar; 2020(1): 2834816. doi: 10.1155/2020/2834816.

Wu K, Xu Y, Zhang L, Zhang Y, Xu W, Chu J et al. Which implant is better for beginners to learn to treat geriatric intertrochanteric femur fractures: A randomised controlled trial of surgeons, metalwork, and patients. Journal of Orthopaedic Translation. 2020 Mar; 21: 18-23. doi: 10.1016/j.jot.2019.11.003.

Zhang K, Zhang S, Yang J, Dong W, Wang S, Cheng Y et al. Proximal femoral nail vs. dynamic hip screw in treatment of intertrochanteric fractures: a meta-analysis. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. 2014 Sep; 20: 1628. doi: 10.12659/MSM.890962.

Jonnes C, Shishir SM, Najimudeen S. Type II intertrochanteric fractures: proximal femoral nailing (PFN) versus dynamic hip screw (DHS). Archives of Bone and Joint Surgery. 2016 Jan; 4(1): 23.

Li XP, Zhang P, Zhu SW, Yang MH, Wu XB, Jiang XY. All-cause mortality risk in aged femoral intertrochanteric fracture patients. Journal of Orthopaedic Surgery and Research. 2021 Dec; 16: 1-8. doi: 10.1186/s13018-021-02874-9.

Marmor M, Guenthner G, Rezaei A, Saam M, Matityahu A. Reporting on quality of reduction and fixation of intertrochanteric fractures-A systematic review. Injury. 2021 Mar; 52(3): 324-9. doi: 10.1016/j.injury.2021.02.014.

Shiraz S, Shujauddin M, Hasan K, Elramadi A, Ahmed G. Comparison of dynamic hip screw and proximal femoral nailing techniques in stable intertrochanteric fractures. Cureus. 2023 Jan; 15(1). doi: 10.7759/cureus.33366.

Yan M, Kuang L, Ni J, Ding M, Wang J, Huang J et al. Use of a double reverse traction repositor versus a traction table for the treatment of intertrochanteric femur fractures: a comparative study. Orthopaedic Surgery. 2021 Jun; 13(4): 1254-61. doi: 10.1111/os.12956.

Pitts CC, Montgomery TP, Hess MC, Smith WR, Quade JH. Reamed Versus Unreamed Intertrochanteric Femur Fractures, Is It Time?. Journal of orthopaedic trauma. 2020 May; 34(5): 252-7. doi: 10.1097/BOT.0000000000001687.

Yu W, Zhang X, Zhu X, Yu Z, Xu Y, Zha G et al. Proximal femoral nails anti-rotation versus dynamic hip screws for treatment of stable intertrochanteric femur fractures: an outcome analyses with a minimum 4 years of follow-up. BioMed Central Musculoskeletal Disorders. 2016 Dec; 17: 1-6. doi: 10.1186/s12891-016-1079-7.

Pajarinen J, Lindahl J, Michelsson O, Savolainen V, Hirvensalo E. Pertrochanteric femoral fractures treated with a dynamic hip screw or a proximal femoral nail: a randomised study comparing post-operative rehabilitation. The Journal of Bone and Joint Surgery British Volume. 2005 Jan; 87(1): 76-81. doi: 10.1302/0301-620X.87B1.15249.

Karayiannis P and James A. The impact of cerclage cabling on unstable intertrochanteric and subtrochanteric femoral fractures: a retrospective review of 465 patients. European Journal of Trauma and Emergency Surgery. 2020 Oct; 46: 969-75. doi: 10.1007/s00068-018-01071-4.

Kong M, Tang Y, Tong F, Guo H, Zhang XL, Zhou L et al. The analgesic efficacy of pericapsular nerve group block in patients with intertrochanteric femur fracture: A Randomized Controlled Trial. PLOS One. 2022 Oct; 17(10): e0275793. doi: 10.1371/journal.pone.0275793.

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Published

2024-10-31
CITATION
DOI: 10.54393/pjhs.v5i10.1892
Published: 2024-10-31

How to Cite

Ali, M. R., Ahmad, I., Ahmed, N. N., Shahzad, M. F., Umer, Y., Lavisha, ., & Shahzad, S. (2024). Assessment of the Proximal Femoral Nailing and Dynamic Hip Screws in Intertrochanteric Fractures: Femoral Nailing and Hip Screws. Pakistan Journal of Health Sciences, 5(10), 114–118. https://doi.org/10.54393/pjhs.v5i10.1892

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