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IP International Journal of Orthopaedic Rheumatology


Comparative Analysis of the Results of Trochanteric Femoral Nail and Dynamic Hip Screw in Treatment of Comminuted Unstable Trochanteric Fractures – a Prospective Randomised Controlled Trial on Indian


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Author Details: Subhadip Mandal, Nitin Kumar, Utpal Banerjee, Debjyoti Roy, Subhajyoti Mandal

Volume : 1

Issue : 1

Online ISSN : 2581-9151

Print ISSN : 2581-8112

Article First Page : 12

Article End Page : 19


Abstract

Background and Purpose: This study aimed to compare the results regarding functional outcome and rate of complications of the Trochanteric Femoral Nail device (TFN) with the Dynamic Hip Screw (DHS), in patients with comminuted unstable trochanteric fractures (AO 2.2 to AO 3.3).
Method: In this prospective, randomized study, total of 160 patients were randomized to the TFN group [Group A (n = 80)] and the DHS group [Group B (n = 80)]. All relevant perioperative information and complications were recorded, and assessments of functional outcome were made.
Results: The mean ± SD operative time was significantly longer in the group B (87.05 ± 17.36 min) than in the group A (68.55 ± 14 min) (P < 0.05). The mean ± SD fluoroscopy time was significantly longer in the group A (5.60 ± 1.32 min) compared with the group B (3.35 ± 0.75 min) (P < 0.05). The mean ± SD external blood loss during surgery was significantly lower in the group A (124 ± 18.2 ml) compared with the group B (240 ± 57.17 ml) (P < 0.05). In the present study group average hospital stay for the patients treated with DHS (Group B) was 15.5 days (range 8 to 33 days) and in case of TFN (Group A) average hospital stay was 12.5 days (range 7 to 28 days), not statistically significant at all. Union both clinically and radio logically had been achieved in all cases. Statistically significant differences were found in the complication rate between the two treatment groups regarding the rate of reoperation. Regarding functional outcome assessment by Harris Hip Score, there were no statistically significant differences between the two groups at the end of 6 months.
Conclusion: The present study showed that the TFN device can be used effectively to treat trochanteric fractures and may be the best choice particularly in unstable trochanteric fractures because of its low re-operation rate.

Keywords: Trochanteric Femoral Nail, Dynamic Hip Screw, Comminuted Unstable Trochanteric Fractures, Cut – out of screws, Rate of re – operation