Dynamic Hip Screw Versus Proximal Femoral Nail in Treatment of Unstable Intertrochanteric Fracture of Femur AO/OTA Types 31 A2 and 31A3 in Patients above Sixty Years Old. A Comparative Study

Background and objectives: Intertrochanteric fracture of the femur is one of the common and challenging fractures in the orthopedic field, which mostly affect old osteoporotic patients. Different method of fixation used to treat inter- trochanteric fracture of femur, including dynamic hip screws an...

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Main Authors: Rebar Nadhem Abdulrahman, Yousif Rashid Mohammed, Zainab Abdulwahab
Format: Article
Language:English
Published: Kurdistan Higher Council Of Medical Specialties 2023-03-01
Series:Advanced Medical Journal
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Online Access:https://amj.khcms.edu.krd/index.php/main/article/view/156
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author Rebar Nadhem Abdulrahman
Yousif Rashid Mohammed
Zainab Abdulwahab
author_facet Rebar Nadhem Abdulrahman
Yousif Rashid Mohammed
Zainab Abdulwahab
author_sort Rebar Nadhem Abdulrahman
collection DOAJ
description Background and objectives: Intertrochanteric fracture of the femur is one of the common and challenging fractures in the orthopedic field, which mostly affect old osteoporotic patients. Different method of fixation used to treat inter- trochanteric fracture of femur, including dynamic hip screws and proximal femoral nail .We compared the dynamic hip screw and proximal femoral nail methods of fixation in unstable intertrochanteric fracture of femur (AO Types A2 and A3) with respect to duration of surgery, blood loss, intraoperative complications, union rate and functional return. Methods:A prospective randomized and comparative study was conducted on forty two patients, 26 males (61.9%), 16 females (38.1%), from March 2015 to March 2017. Out of 42 cases, 20 patients (47.6%) treated with dynamic hip screw (group A) and 22 patients (52.4%) with proximal femoral nail (group B). In this study, maximum age was 80 years and minimum was 60 years old with a mean age of 70.9 years. Results: Our study found that proximal femoral nail fixation had relatively lesser operative time (74.5+2.6 minutes in dynamic hip screw group and 57+2.3 minutes in proximal femoral nail group), less blood loss observed (150±10.7 ml in dynamic hip screw group and 90±6.7 ml in proximal femoral nail group) and the patients were capable of early mobilization and lesser rates of implant failures (2 cases in dynamic hip screw group with no case in proximal femoral nail group), however, dynamic hip screw patients showed faster fracture healing (12-16 weeks in dynamic hip screw group and 16-24 weeks in proximal femoral nail group). Conclusions:Proximal femoral nail provides more stable fixation for unstable intertrochanteric fractures spe- cially AO type 31A3 and has more favorable short-term outcomes with a shorter procedure duration, less blood loss and no implant failures.  
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spelling doaj-art-24fd55758ff94973b5d6f28600ffbf6e2025-08-20T02:13:01ZengKurdistan Higher Council Of Medical SpecialtiesAdvanced Medical Journal2958-89792957-35802023-03-014110.56056/amj.2018.49157Dynamic Hip Screw Versus Proximal Femoral Nail in Treatment of Unstable Intertrochanteric Fracture of Femur AO/OTA Types 31 A2 and 31A3 in Patients above Sixty Years Old. A Comparative StudyRebar Nadhem Abdulrahman0Yousif Rashid Mohammed1Zainab Abdulwahab2M.B.Ch.B, candidate of KBMS, department of orthopedic surgeryM.B.Ch.B, M.R.C.S (Glas.), consultant orthopedic surgery, lecturer at college of medicine, Hawler medical university, department of orthopedic surgery, Erbil teaching hospital.M.B.Ch.B, F.I.B.M.S (ortho.), lecturer at college of medicine, Hawler medical university, department of orthopedic surgery, Erbil teaching hospital. Background and objectives: Intertrochanteric fracture of the femur is one of the common and challenging fractures in the orthopedic field, which mostly affect old osteoporotic patients. Different method of fixation used to treat inter- trochanteric fracture of femur, including dynamic hip screws and proximal femoral nail .We compared the dynamic hip screw and proximal femoral nail methods of fixation in unstable intertrochanteric fracture of femur (AO Types A2 and A3) with respect to duration of surgery, blood loss, intraoperative complications, union rate and functional return. Methods:A prospective randomized and comparative study was conducted on forty two patients, 26 males (61.9%), 16 females (38.1%), from March 2015 to March 2017. Out of 42 cases, 20 patients (47.6%) treated with dynamic hip screw (group A) and 22 patients (52.4%) with proximal femoral nail (group B). In this study, maximum age was 80 years and minimum was 60 years old with a mean age of 70.9 years. Results: Our study found that proximal femoral nail fixation had relatively lesser operative time (74.5+2.6 minutes in dynamic hip screw group and 57+2.3 minutes in proximal femoral nail group), less blood loss observed (150±10.7 ml in dynamic hip screw group and 90±6.7 ml in proximal femoral nail group) and the patients were capable of early mobilization and lesser rates of implant failures (2 cases in dynamic hip screw group with no case in proximal femoral nail group), however, dynamic hip screw patients showed faster fracture healing (12-16 weeks in dynamic hip screw group and 16-24 weeks in proximal femoral nail group). Conclusions:Proximal femoral nail provides more stable fixation for unstable intertrochanteric fractures spe- cially AO type 31A3 and has more favorable short-term outcomes with a shorter procedure duration, less blood loss and no implant failures.   https://amj.khcms.edu.krd/index.php/main/article/view/156Intertrochanteric fractureProximal femoral nailDynamic hip screw
spellingShingle Rebar Nadhem Abdulrahman
Yousif Rashid Mohammed
Zainab Abdulwahab
Dynamic Hip Screw Versus Proximal Femoral Nail in Treatment of Unstable Intertrochanteric Fracture of Femur AO/OTA Types 31 A2 and 31A3 in Patients above Sixty Years Old. A Comparative Study
Advanced Medical Journal
Intertrochanteric fracture
Proximal femoral nail
Dynamic hip screw
title Dynamic Hip Screw Versus Proximal Femoral Nail in Treatment of Unstable Intertrochanteric Fracture of Femur AO/OTA Types 31 A2 and 31A3 in Patients above Sixty Years Old. A Comparative Study
title_full Dynamic Hip Screw Versus Proximal Femoral Nail in Treatment of Unstable Intertrochanteric Fracture of Femur AO/OTA Types 31 A2 and 31A3 in Patients above Sixty Years Old. A Comparative Study
title_fullStr Dynamic Hip Screw Versus Proximal Femoral Nail in Treatment of Unstable Intertrochanteric Fracture of Femur AO/OTA Types 31 A2 and 31A3 in Patients above Sixty Years Old. A Comparative Study
title_full_unstemmed Dynamic Hip Screw Versus Proximal Femoral Nail in Treatment of Unstable Intertrochanteric Fracture of Femur AO/OTA Types 31 A2 and 31A3 in Patients above Sixty Years Old. A Comparative Study
title_short Dynamic Hip Screw Versus Proximal Femoral Nail in Treatment of Unstable Intertrochanteric Fracture of Femur AO/OTA Types 31 A2 and 31A3 in Patients above Sixty Years Old. A Comparative Study
title_sort dynamic hip screw versus proximal femoral nail in treatment of unstable intertrochanteric fracture of femur ao ota types 31 a2 and 31a3 in patients above sixty years old a comparative study
topic Intertrochanteric fracture
Proximal femoral nail
Dynamic hip screw
url https://amj.khcms.edu.krd/index.php/main/article/view/156
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