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Comparative study of the clinical and radiological outcome of subtrochanteric fracture femur fixed by dynamic condylar screw (DCS) and long proximal femur nail (PFN)

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Original Article

Author Details : Virupaksha B Kachewar, Ganesh N Pundkar*, Bhaskar D Bute, Ujwal G Wankhade

Volume : 6, Issue : 4, Year : 2020

Article Page : 311-315

https://doi.org/10.18231/j.ijos.2020.057

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Abstract

Background: Subtrochanteric fractures are included among those injuries caused by severe high energy trauma in the younger population. However, in the older population, this particular hip injury is caused by trivial fall and osteoporotic bones in the elderly population. It is difficult to treat these kinds of fractures
easily. In order to avoid major complication such as mortality, the early surgical treatment regime is required to be followed.
Aim: To compare and study the clinical and radiological outcome of subtrochanteric fracture femur fixed by Dynamic Condylar Screw (DCS) and Long Proximal Femur Nail (PFN)
Materials and Methods: Total of 30 patients was included in the study. Simple randomization technique was employed to categorized patients for either PFN treatment or DCS treatment. Fifteen patients out of 30 were treated using PFN, and the remaining 15 were treated using DCS using close reduction. The study
period was from July 2017 to June 2019. All the patients with subtrochanteric femur fractures within two weeks of injury were included for the study. Patients’ follow-up was done at 6-weeks, 3-months, and 6 months.
Results: The highest number of patients, i.e. 40%, was aged between 51 and 60 years with the mean age of 58.231.26 years. The number of male patients (66.66%) was higher as compared to female patients. The mode of treatment for 50% of patients was PFN while it was DCS for the remaining 50% of the
patients. The highest number of patients, i.e., 50% had Type III femur fracture. The patients treated using PFN showed improved functional outcome as compared to the patients treated using DCS. The patients were able to bear full weight within five weeks of surgery. The mean union time for patients treated with PFN was 16 weeks, while the mean union time in patients treated with DCS was 19 weeks. Also, the mean Harris Hip Score for patients treated with PFN was 90 and for the patients treated with DCS was 85.
Conclusion: In light of the above results and literature, it was clear that PFN was a better surgical intervention as compared to DCS. It required a shorter operation duration and rehabilitation time. The patients treated with PFN showed improved functional outcomes as compared to the patients treated with DCS.

Keywords: Dynamic condylar screw (DCS), Proximal femur nail (PFN), Subtrochanteric fracture femur.

How to cite : Kachewar V B, Pundkar G N, Bute B D, Wankhade U G, Comparative study of the clinical and radiological outcome of subtrochanteric fracture femur fixed by dynamic condylar screw (DCS) and long proximal femur nail (PFN). Indian J Orthop Surg 2020;6(4):311-315

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