“SURGICAL MANAGEMENT OF SUBTROCHANTERIC FEMORAL FRACTURES BY PFN AND DCS - A COMPARATIVE STUDY”

Abstract

Background: The treatment of Subtrochanteric fractures continues to be a challenge in orthopaedic trauma, especially in geriatric population. Among the various surgical technique- Proximal Femoral Nail (PFN) and Dynamic Condylar Screw (DCS) are the ideally sought implants for xation. Aims and objectives: This study was designed to assess the clinical, functional and radiological outcomes and complications of femoral subtrochanteric fractures treated with PFN and DCS Methodology: This is a prospective observational study of 35 cases of subtrochanteric femoral fractures admitted to KIMS hospital, Hubballi, Karnataka. These 35 cases then randomized into two groups of PFN and DCS. All patients were followed up with radiographs for every 4 weeks th for 3 months and on 6 month and outcome was assessed using modied Harris Hip Score. Results: In our study, mean duration of hospital stay was found to be 11.23 ± 3.038 days in PFN group and 14.08 ± 2.178 days in DCS group and mean time for union was 14.91 ± 3.006 weeks in PFN group and 17.33 ± 2.871 in DCS group. Good to excellent results were seen in 81.82% of subtrochanteric fractures in PFN group and 53.85% in DCS group. Conclusion: From this study, we conclude that, functionally there were no signicant difference between DCS and PFN but, PFN has advantages in terms of faster surgical procedure, less blood loss, shorter hospital stays and less time for union. However, in complex subtrochanteric fractures DCS denitely a reliable and a backup implant.