Comparison Of PFN And DHS In Treatment Of Unstable Intertrochanteric Fracture

Objective:To compare the significance of Proximal femoral nail (PFN) and dynamic hip screw (DHS) which are both used for the fixation of unstable intertrochanteric fractures.Methods: 39 patients who underwent PFN were retrospectively compared with 27 patients who underwent dynamic hip screw (DHS) fixation in the orthopaedic department of 1st hospital Jilin university from October 2001 to February 2009. The data of each group were collected for statistically analysis on the following aspects: age, sex, type of fractures,energy factor of injury, ASA score, anesthesia type, length of incision, blood loss,blood transfusion, operative time, postoperative drainage, systemic complication, local complication, length of hospitalization, mortality, consolidation and subtraction between preoperative and postoperative Merle D'Aubigne score. The statistical analysis was performed using SPSS13.0 (statistics package for social science) software. For approximately normally distributed variables, the arithmetic mean±standard deviation and the independent sample Student's test were used. For abnormally distributed variables, the median was used for evaluation whereas the Mann-Whitney U test was used for comparison between groups. X2 test was used for comparison between the constitution of two groups.Differences were considered to be significant at a level of P<0.05.Results: The general characteristics of the two groups, including age, type of fractures, energy factor of injury and ASA score were similar except sex. The constitution of anesthesia type in two groups is significantly different (P<0.05), the number of general anesthesia is more in PFN group than that in DHS group. The blood loss duing operation in PFN group was less than that in DHS group (P<0.05). The length of incision in PFN group was shorter than that in DHS group(P<0.05). Blood transfusion, operative time, postoperative drainage, systemic complication, local complication, length of hospitalization, mortality, consolidation, and subtraction between preoperative and postoperative Merle D'Aubigne score were not significantly different.Conclusions: 1.Both of PFN and DHS are useful instruments to supply effective internal fixation for unstable intertrochanteric fractures. 2.PFN offers several advantages over DHS in shorter incision and less blood loss. 3.PFN is one of the optimal choices for orthopaedic surgen in treating unstable intertrochanteric fracture.