July 2026, Volume 4, Issue 7

Author

Amudhaganesh Selvaraj, Ragavan S K S, Sandeep T George and Jeevithan Shanmugam

Abstract

Introduction: Fractures of the femur, especially Intertrochanteric type, is one of the most common fractures in the elderly. It is most commonly caused due to trivial trauma in an already osteoporotic bone. Early surgical fixation can result in early mobilization and reduced morbidity. Usage of the Dynamic Hip Screw (DHS) and Proximal Femoral Nail (PFN) are considered widely for fixation. This study aims to compare the functional and radiological outcomes of intertrochanteric fractures treated with minimally invasive DHS and PFN fixation. Materials and Methods: This study was done prospectively and it was a comparative study conducted in 2017 on 30 participants with intertrochanteric fractures. The study samples were divided equally into DHS and PFN groups, with 15 in each group. Operative parameters, recovery in postoperative period, and functional outcome were assessed by the Harris Hip Score. Serial radiographs were taken till 6 months post operatively to evaluate for radiological union. Results: The mean operative time was significantly lower in the PFN group (52.1 minutes) than in the DHS group (69.9 minutes). PFN allowed earlier full weight bearing (mean 3.6 weeks) compared to DHS (9.5 weeks). The mean Harris Hip Score at six weeks was significantly higher in the PFN group, but by 20 weeks, the difference was not statistically significant. Radiological assessment at six months showed excellent union in 73.3% of DHS cases and 26.7% of PFN cases (p=0.027). Conclusion: Both DHS and PFN are effective fixation methods for intertrochanteric fractures. PFN offers advantages in operative time and early rehabilitation, whereas DHS demonstrated superior radiological union in the present study. Implant selection should be individualized based on fracture characteristics and surgeon expertise.