Comparison of proximal femoral nail and dynamic hip screw for treating intertrochanteric fractures
Keywords:Femur fracture, Osteosynthesis, Mortality
Aim: In this study, the use of proximal femoral nail and dynamic hip screw for treatment of intertrochanteric hip fractures were compared in terms of mortality and morbidity.
Methods: 131 patients who had an operation due to intertrochanteric hip fractures were evaluated demographic characteristics and surgical data (72 female, 59 male, mean age 77.85, range 65-98 years). 98 patients (74.8%) PFN method, 33 patients (25.2%) DHS method was applied. The age and gender of patients, etiology, type of anesthesia, preoperative waiting period, preoperative ASA (American Society Anesthesiologists) score calculated by anesthesia physicians, Singh index, track time, the type of fracture, complication rate, the degree of reduction, tip-apex distance, shortening the existence and mortality were investigated. The Harris Hip Score was used for functional assessment.
Results: The average post-operative follow-up period was 25.23 (1-66) months. The group that were applied DHS were found significantly different for reduction success (p<0.05). Harris Hip Scoring of patients in the DHS group were found significantly better (p<0.05). The success of the reduction in the DHS group was significantly related with the Harris HipScore (p<0.05).
Conclusion: We have concluded that the preoperative waiting time has no impact on mortality, increasing age increases the systemic disease, therefore increases ASA score. So that increasing ASA score increases the mortality. Unstable intertrochanteric fractures of the femur PFNA, due to the higher success rate of reduction should be preferred. But between two methods there were no significant differences about healing time and mortality. In conclusion, surgical techniques to be used should be selected according to the fracture type and age of the patient.
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