[Proximal femoral intramedullary nail versus DHS plate for the treatment of intertrochanteric fractures. A prospective analysis].

Abstract

OBJECTIVE: To show that patients with intertrochanteric fractures treated with a proximal femoral nail have a better postoperative course than those treated with a DHS plate (dynamic hip screw). METHODS: Patients with a Boyd & Griffin type II intertrochanteric fracture were randomly divided into two groups: a group of patients treated with a PFN and another one treated with a DHS plate. All patients were assessed at 2, 4, 8 and 16 weeks using the Harris scale and the visual analog scale pre- and postoperatively, as well as the operative time, incision size, intraoperative bleeding, onset of partial and/or total weight bearing, healing time, time to attain prior physical activity level, and radiographic result. RESULTS: 32 patients met our criteria. The variables that had a significant reduction were: incision, operative time, postoperative pain according to the visual analog scale, onset of mobility, partial weight bearing and pain at 2 weeks. CONCLUSIONS: The proximal femoral nail has better short-term outcomes than the DHS plate; however, in the medium term both implants have the same outcomes.