Dhs And Pfn Treatment Of Intertrochanteric Fractures Of The Comparative Analysis

The comparative and analysis of the treatment to intertrochanteric femoral fractures with DHS and PFNObjective To compare and analyze the post-complications after the treatment of intertrochanteric femoral fractures with DHS (dynamic hip screw) and PFN (proximal femoral nail)Method From June 2002 to september 2006, 118 cases with intertrochanteric femoral fractures were divided into DHS and PFN groups randomly. DHS group (64 cases) included Tronzo and Evens typeⅠ18 cases, typeⅡ20 cases, typeⅢ20 cases, typeⅣ6 cases. We used Sighn classification as a measure of osteoporosis, 14 cases combined with osteoporosis(Singh index underⅢ). PFN group (54 cases) included Tronzo and Evens typeⅠ16 cases, typeⅡ14 cases, typeⅢ14 cases, typeⅣ6cases, typeⅤ4cases. 14 cases combined with osteoporosis(Singh index underⅢ). All cases were follow-up 9-10 months with a mean of 10.2 months, To compare the average fracture healing time, cut-out of lap screw, hip varus, length of lap between two groups.Results The average fracture healing time was 2.7 months in DHS group and 2.2 months in PFN group, there were no significant difference. Among all cases, DHS group 2 cases and PFN group 2 cases were found cut-out of lap screw and all combined with osteoporosis(Singh index underⅢ), there were no statistical significatnce (P＞0.05). Hip varus between two groups, DHS group 8 cases and PFN group 3 cases, there was significant difference (P＜0.05). The diseased site in DHS group was averagely 1.4cm shorter than the healthy site; that was 0.8cm in PFN group, there were statistical significatnce (P＜0.05) between two groups. The pain was the feeling patient-self, we didn't compare the difference between two groups.Conclusion By comparision, DHS and PFN all could be used for stable intertrochanteric fractures(Tronzo and Evens typeⅠ,Ⅱ), PFN was more suitable than DHS for unstable intertrochanteric fractures(Tronzo and Evens typeⅢ,Ⅳ,Ⅴ). To chosen suitable internal fixation materials was difficult for the cases with serious osteoporosis.