A COMPARISON OF AO DYNAMIC CONDYLAR SCREWS (DCS) VS PROXIMAL FEMORAL NAIL ANTIROTATION (PFNA) FOR THE TREATMENT OF UNSTABLE PERITROCHANTERIC FEMORAL FRACTURES, A RETROSPECTIVE STUDY
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Abstract
Purpose: The purpose of this study was to compare the outcomes of intramedullary fixation versus plate-screw fixation for unstable peritrochanteric femoral fracture patients over the age of 60.
Methods: A retrospective analysis of patients who had unstable peritrochanteric femoral fractures and were treated with a 95° fixed-angle screw plate (DCS) or an intramedullary nailing device (PFNA) is presented in this article. The study covered 73 fractures, 41 of whom were operated with the PFNA system and 32 with the DCS. The treatment groups were compared over the period of atleast 1 year, considering all demographic and trauma parameters.
Results: At the 1-year follow-up, no significant differences in age, gender, side of injury, mechanism of trauma, associated comorbidities, AO fracture classification, mortality at one year, functional score or fracture reduction quality were seen between the two groups. The PFNA group had a shorter surgical time (80.46±12.74 mins) than the DCS group (93.94±13.89mins.). In the DCS group, as more exposure and surgical time was required, resulting in more blood loss, length of hospital stay and late weight bearing than in the PFNA group. The PFNA group's in term of postoperative functional outcomes were found to be much better than the DCS group's.
Conclusions: PFNA is a more suitable choice for the treatment of unstable peritrochanteric fracture because of some advantages such as minimal exposure, less surgical time, blood loss, hospital stay, weight bearing and better postoperative functional results.
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Muhammad Badar Ud Din Zafir
Assistant Professor of Orthopaedic Surgery, Nishtar II Teaching Hospital/Nishtar Medical University, Multan - Pakistan
Muhammad Kamran Shafi
Assistant Professor of Orthopaedic Surgery, Nishtar Medical University, Multan - Pakistan
Ghulam Qadir Khan
Associate Professor of Orthopaedic Surgery, Nishtar Medical University, Multan - Pakistan
Behzad Manzoor
Senior Registrar of Orthopaedic Surgery, Ibne Sina Hospital and Research Institute, Multan - Pakistan
Israr Ahmad
Assistant Professor of Orthopaedic Surgery, Ibne Sina Hospital and Research Institute, Multan - Pakistan