A comparative study of outcomes of pertrochanteric fracture (AO Type - 31A2) treated with dynamic hip screw & proximal femoral nail
Dr. Mukesh Kumar, Dr. VK Bhaskaran, Dr. Chandrababu KK, Dr. Adnan Zahoor
Background: Intertrochanteric fracture, a common fracture in the elderly accounting for almost 30% patients admitted in orthopaedics wards is associated with significant morbidity and a mortality rate as much as 15 -20 % if not properly treated. Current concept for intertrochanteric fracture fixation is for AO Type 31A1 fracture the choice of implants is DHS while for AO Type- 31A3, the choice of implant is Proximal Femoral Nail. But there is dilemma about the choice of implants between Intramedullary Nail and Dynamic Hip Screw for AO Type 31A2 fracture. This study was intended to compare the outcome of both DHS & PFN in AO Type 31A2 fracture. Methods: This study was conducted in Department of Orthopaedics, Sudhamayi Clinics and Hospital) between June – 2011 to May 2013. Sample size was total of 45 with 23 in PFN group and 22 in DHS group, all the patients who were admitted in our hospital with intertrochanteric fracture AO Type 31A2 between May 2010 and May 2011 were considered for this study. Total of 45 cases was included in the study. 22 cases in DHS group & 23 cases in PFN group. The total of 45 cases was randomly allocated to two groups. Data was collected primarily through direct patient review & Electronic Medical Record. AO Classification was used for fracture classification, Palmer & Parker Mobility score was used to record Preinjury & Post surgery Mobility status. Jensen Index was used to asses’ social functional status. Results: The change in mobility score was slightly higher in PFN group which was statistically insignificant, Blood loss was significantly low in PFN group. The mean T SCORE for both group was -2.44. There was no significant difference in post op mobility score. Conclusion: There was no significant difference between two groups other than more blood loss in DHS group. Average T Score was higher which is suggestive of Bone Fragility. Level of Evidence: Therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence.