Dynamic hip screws versus proximal femoral nails for intertrochanteric fractures

Authors


  • Z. Avakian MBBS (Hons), BMedSci; T. Shiraev BSc (Hons); L. Lam MPH, PhD; N. Hope PhD, FAOrthA.

Associate Professor Nigel Hope, Sydney Adventist Hospital, 185 Fox Valley Road, Wahroonga, Sydney, NSW 2076, Australia. Email: nigelhope@bigpond.com

Abstract

Background:  It is essential to determine the optimal treatment of intertrochanteric fractures due to their high incidence and related public health burden. Debate remains as to whether dynamic hip screws (DHS) or proximal femoral nails (PFNs) are best practice, and this pilot study seeks to collect information relevant to this query.

Methods:  We undertook a retrospective audit of 144 patients who received a dynamic hip screw or a proximal femoral nail in order to compare age, sex, duration of surgery, duration of hospitalization, time of first mobilization, and rate anaemia, sepsis, avascular necrosis, prosthesis failure, revision, deep vein thrombosis, pulmonary embolus, non-ST elevation myocardial infarction, common peroneal nerve palsy and death between implantation of a DHS and a PFN.

Results:  No differences were found between groups in age, duration of surgery, duration of hospitalization, time of first mobilization and rate of complications. Statistically significant differences were found in sex distributions, operation time and length of stay. However, analysis of median operation time and length of stay when adjusted for sex revealed no significant differences.

Conclusion:  This study demonstrated no statistically significant differences in peri- and post-operative measures between patients undergoing intertrochanteric fracture fixation via PFN or DHS. This is the only data from Australian hospitals, and further national research is needed.

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