Most studies reported that lag screw position might be associated with the rate of cut-out in DHS fixation. In one case, iatrogenic fracture of the lateral cortex of the proximal fragment was noted, which was minimally displaced. Verhofstad MH, van der Werken C. Background The incidence of intertrochanteric fractures has been increasing significantly due to the rising age of modern human populations [ 1 , 2 ]. Firstly, the number of studies included and the sample size of patients were quite limited. Though both PFN and DHS have similar functional outcome in stable fracture and PFN has better function outcome with unstable fractures, PFN requires shorter operative time and a smaller incision, it has distinct advantages over DHS even in stable intertrochanteric fractures. Four studies [ 10 , 11 , 13 , 15 ] provided data on lag screw cut-out rate.
All databases were searched from the earliest records to August Table 1 Description of the studies included in the meta-analysis. In our series we found that PFN was superior to DHS in many ways such as reduced intra-operative blood loss, lesser operative time, reduced radiation exposure, less amount of shortening, reduced hospital stay, lesser infection rates and early mobilization. Pertrochanteric femoral fractures treated with a dynamic hip screw or a proximal femoral nail: Fractures and dislocations of the hip. Methods This was a prospective randomized study conducted in M. Duration from the day of surgery to mobilization.
Furthermore, not all the studies included had long enough follow-up periods, which also reduces the power of our research.
Intra-operative blood loss, duration of surgery and intra-operative radiation exposure. Right side was affected in 24 cases and left in 26 cases.
Bucholz and James D.
Clin Orthop ; ; Right side was affected in 24 cases and left in 26 cases. A new device for the treatment of unstable proximal femoral fractures. We searched for randomized or quasi-randomized controlled studies comparing the effects of PFN and Theeis according to the search strategy of the Cochrane Collaboration.
Two studies [ 1215 ] provided data on length of incision.
Author information Article notes Copyright and License information Disclaimer. Flowchart of study search and selection for the meta-analysis. In one case, with delay in surgery of 11 days was noted as hds patient was not fit to be taken up for surgery. No post-operative complications were seen in PFN series. Support Center Support Center. JBJS ; 75 5 Proximal femoral nailing creates a shorter lever arm, which translates to a lower bending moment and a decreased rate of mechanical failure Belg, ; 60 ; Your Comments on this Article Cancel reply.
The incidence of subtrochanteric femoral fractures has increased significantly during recent decades, and this tendency will probably continue in the near future owing to the considerable increase in the life expectancy leading to an increasing geriatric population.
The fractures were classified according to Seinsheimer’s classification. In this study, an attempt has been made to review the literature and compare our results with other studies.
One case of breakage of implant in situ at 5 months was noticed. Duration of stay at hospital. Proximal femoral nailing creates a shorter lever arm, which translates ;fn a lower bending moment and a decreased rate of mechanical failure Harper MC, Walsh T: Though both PFN and DHS have similar functional outcome in stable fracture and PFN has better thrsis outcome with unstable fractures, PFN requires shorter operative time and a smaller incision, it has distinct advantages over DHS even in stable intertrochanteric fractures.
However pfm treatment usually resulted in malunion. However, both benefits and technical failures of PFN have been reported [ 7 — 9 ]. We found that PFN was superior to DHS in many ways such as dgs intra-operative blood loss, lesser operative time, reduced radiation exposure, less amount of limb shortening, reduced hospital stay, lesser infection rates and early mobilization.
However, both benefits and technical failures of PFN have been reported [ 7 — 9 ] Although the effects of PFN and DHS in treatment of intertrochanteric fractures have been reported, the results dbs conclusions are not consistent [ 10 — 15 ].
Among them, 13 trials met the thesls criteria. Operative time minintraoperative blood loss mllength of incision, post-operative infection, lag screw cut-out rate, and reoperation rate were the main measures in the studies included, which the present meta-analysis evaluated to compare the effects of PFN and DHS. Full texts of citations that could possibly be included in the present dsh were retrieved for further analysis. We did not include the possibility of publishing bias due to the small number of studies included.
Aprospective randomised comparison of the dynamic hip screw and the gamma locking nail.
Males were 37 and females