Evaluation of Results of Unstable Intertrochanteric Femoral Fracture Fixation by Proximal Femoral Nail "PFN " Versus Dynamic Hip Screw

Document Type : Original research articles

Authors

Orthopedic Surgery & Traumatology Department, Faculty of Medicine, South Valley University, Qena, Egypt

Abstract

Background: The most common implant used for intertrochanteric fractures is the dynamic hip screw (DHS). For the treatment of unstable fractures, cephalo-medullary devices are recommended, especially in cases where medial buttressing is absent. The proximal femoral nail (PFN) was devised by the AO/ASIF and included an additional anti-rotation hip pin, a lower load-bearing neck screw, and two proximal screws.
Objectives: To assess outcomes of unstable Intertrochanteric Femoral Fracture fixation using Proximal Femoral Nails (PFN) versus DHS.
Patients and methods: This prospective study was carried out on 40 patients with clinical criteria of unstable intertrochanteric femur fracture. Patients were divided into two equal groups: PFN group and DHS group.
Results: Incision length and fluoroscopy time were significantly higher in DHS group than PFN group (P value=0.001 and 0.002). VAS showed non-significant differences. Aid usage, union time, full weightbearing time, infection, non-union, lag screw cut through, metal failure and for revision were insignificantly different between both groups. Malunion didn’t occur in any patient in both groups.
Conclusion: Our study found no significant difference between PFN and DHS with regards to pain scores, Harris hip scores, gait patterns, ambulation distances, assistive device utilization, time to union, time to full weight-bearing, and postoperative complication rates. However, the DHS technique was associated with a larger incision length and increased fluoroscopy time compared to the PFN technique.

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SVU-International Journal of Medical Sciences
Volume 8, Issue 2
July-December
July 2025
Pages 289-299

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