A Comparative Study between Dynamic Hip Screw and Proximal Femoral Nail in Fixing Intertrochanteric Fractures

Document Type : Original Article

Authors

1 Department of Orthopedic Surgery, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.

2 Department of Orthopedic Surgery, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt.

3 Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, Minia University, Minia. Egypt.

Abstract

Background: Among the elderly, intertrochanteric fractures are among the most commonly encountered fractures.
Aim of the work: The goal was to assess the dynamic hip screw [DHS] versus interlocking nail in the treatment of intertrochanteric fractures, focusing on fracture union, complications, and functional outcomes.
Patients and Methods: In this prospective randomized control trial, 40 patients with intertrochanteric fractures were treated using either a DHS or an interlocking nail at the duration from September 2022 to March 2024. which 20 cases were managed by DHS [group І] and also, 20 cases were managed by GAMMA Nail [group ІІ]
Results: Key differences between the two groups were found. Group I had a significantly higher rate of blood transfusions compared to Group II [p < 0.001], but there were no significant differences in surgery duration or timing between the groups. In terms of outcomes, Group I showed a higher proportion of unsatisfactory functional results despite having satisfactory anatomical outcomes, whereas Group II demonstrated better alignment between anatomical and functional results. Additionally, for patients under 65, Group I had more satisfactory functional outcomes. Smoking was found to be associated with poorer functional results and longer time to union in Group I, but this effect was not observed in Group II.
Conclusion: The Gamma Nail [Group II] showed better anatomical-functional alignment, while Group I had more unsatisfactory functional results and required more blood transfusions. However, Group I performed better in younger patients under 65, suggesting it may be more effective for them. 

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