J Korean Hip Soc.  2007 Sep;19(3):167-175. 10.5371/jkhs.2007.19.3.167.

The Treatment of Peritrochanteric Fracture of Femur with Proximal Femoral Nail: Comparative Study with Dynamic Hip Screw

• Chung YK
• Hwang JH
• Kim HK

• KMID: 1811334
• DOI: http://doi.org/10.5371/jkhs.2007.19.3.167

Abstract

PURPOSE
This study compared the results between PFN (Proximal Femoral Nail) and DHS (Dynamic Hip Screw)in the treatment of a peritrochanteric fracture of the proximal femur.
MATERIALS AND METHODS
33 patients with peritrochanteric fractures treated with PFN for a minimum follow-up of at least 12 months were analyzed retrospectively. The patients with PFN group (n=33, group I) were taken from operations between Jan. 2003 and Dec. 2004, and the DHS group (n=34, group II) were used as the control group. Both groups were compared with regard to the operation time, blood loss, transfusion, ICU care, drain amount, duration of admission, complications, the neck shaft angle, the sliding length of lag screws, radiological union, and the functional recovery grade using Jensen and Palmar and Parker's method.
RESULTS
The mean operative times were 105 (group I) and 157 minutes (group II), blood losses were 540 and 840cc, transfusion volumes were 1.5 and 2.2 pints, ICU care was 6 and 30%, drain amounts were 36 and 203 cc, admission duration was 25 and 33 days, complications were 15 and 17%, reoperations by the failure of the reduction were 2 cases(6%) (group I) and 0 (group II), difference in the neck shaft angles were 3.70 and 3.87degrees, sliding length of the lag screws were 1.9 and 6.9 mm, radiological union was achieved in 17.5 and 18.9 weeks, function scores were 1.81 and 1.94, and the mobility scores were 6.51 and 6.16, respectively. These results show that there were advantages of PFN in terms of the operative times, blood loss, transfusion, ICU care, drain amounts, admission duration, sliding length of the lag screws and radiological union with statistical significance (p<0.05).
CONCLUSION
Good clinical results can be achieved with PFN compared with the DHS for the treatment of peritrochanteric fractures of the proximal femur.

Keyword

Peritrochanteric fracture; Proximal femoral nail; Dynamic hip screw

MeSH Terms

Femur*
Follow-Up Studies
Hip*
Humans
Neck
Operative Time
Retrospective Studies