A Comparative Study Between The Outcomes Of Proximal Femoral Nail Versus Dynamic Hip Screw For The Treatment Of Intertrochanteric Fractures Of The Hip

Abstract

Femur intertrochanteric fractures are frequent injuries, especially in the elderly group of people, which is linked to high morbidity and functional impairment. DHS and Proximal Femur Nail (PFN) are common fixation techniques but the most effective modality of treatment is still under debate. The study aims to compare the results of the operative treatment of Trochanteric Hip Fractures (THF) performed with the help of DHS and PFN concerning the length of operation, period to fracture union and functional outcome. Between March 2024 and March 2026, the Department of Orthopaedics at Sree Balaji Medical College and Hospital in Chennai conducted a prospective comparative study. Thirty intertrochanteric fractured patients were selected and randomly assigned to either DHS (n=15) or PFN (n=15) fixation. Patients were monitored clinically and radiologically at six weeks, twelve weeks, and six months. The outcome measures were the duration of operation, time of fracture union, postoperative complications, pain, mobility, shortening of the limb, range of motion, and functional outcome. PFN fixation recorded shorter operative time, shorter incision, reduced postoperative pain, improved mobility recovery, less limb shortening and greater hip flexion than DHS fixation (p < 0.05). Fluoroscopy exposure time was significantly higher in the PFN group (p < 0.001). Fracture union time was comparable between the two groups (p = 0.83). Although functional outcomes favored PFN, the difference was not statistically substantial. Both DHS and PFN provided satisfactory fracture union and functional recovery. However, PFN offered compensations in operative efficiency and postoperative rehabilitation, suggesting its potential benefit for facilitating earlier functional recovery following intertrochanteric fracture fixation.