Evaluation of clinico- radiological outcomes of treating unstable Intertrochanteric fractures using dynamic hip screw (DHS) with Trochanteric Stabilisation plate (TSP) versus proximal femoral nailing (PFN)

Mohan, Jagan and Karnati, Reddy and Naik, Monappa A and Rao, Sharath K (2016) Evaluation of clinico- radiological outcomes of treating unstable Intertrochanteric fractures using dynamic hip screw (DHS) with Trochanteric Stabilisation plate (TSP) versus proximal femoral nailing (PFN). International Journal of Current Research, 8 (8). pp. 37209-37215. ISSN 0975-833X

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Abstract

Back ground: Unstable intertrochanteric fractures which lack either posteromedial buttress, lateral buttress, or both, after stabilization with a dynamic hip screw (DHS), these fractures tend to have excessive fracture collapse, with significant limb shortening and occasionally fixation failure. In general for treatment of unstable intertrochanteric fractures, two options exist: extra medullary or intramedullary stabilization. Currently controversies still exist about a suitable device for an unstable intertrochanteric fracture. Materials & Methods: Study was undertaken in Department of Orthopaedics, KMC, Manipal between August 2012 and July 2014. A total of 70 cases of unstable intertrochanteric fractures (AO 31 2.2 and above) were randomized into two groups (one group treated with (Dynamic Hip Screw and Trochanteric stabilization plate (DHS+TSP) and other with Proximal Femoral Nailing (PFN) ) as per computer generated randomised table at the time of first presentation to hospital, followed up both clinically and Radiologically. Clinical variables assessed were limp, limb shortening, range of motion, Salvati wilson hip score, Hip abductor power. Radiologically variables like progress of union, varus collapse, and screw cut out were analysed at 6 weeks, 3 months, 6 months and at 1 year Results: 20 cases were lost to follow-up. Remainder study group comprised of 32 males and 18 females with mean age of 68.3 years. All fractures united at mean 16.3 weeks in TSP group and 15.4 weeks for PFN group. There was 1 lag screw back out in TSP group & 2 in PFN group at 6 month follow up. None of the patient required revision surgery. At the end of one year, clinical variables (Limp (P value<0.08), Hip Movements, Hip Score (0.087), limb shortening (P value<0.11), Abductor power) and radiological variables (Varus collapse (P value<0.8)) showed no statistical significance. Statistical data was evaluated with the help of SPSS 21 software using Independent T test. Conclusions: In treatment of unstable trochanteric fractures, DHS+TSP and PFN have comparable clinic-radiological outcomes at the end of one year. However, further studies are required with large sample size and comparable groups.

Item Type: Article
Uncontrolled Keywords: Intertrochanteric fractures; DHS+TSP ; PFN ; Unstable.
Subjects: Medicine > KMC Manipal > Orthopaedics
Depositing User: KMC Library
Date Deposited: 16 Jan 2018 11:09
Last Modified: 16 Jan 2018 11:09
URI: http://eprints.manipal.edu/id/eprint/147867

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