title: Type II Intertrochanteric Fractures: Proximal Femoral Nailing (PFN) Versus Dynamic Hip Screw (DHS).
abstract: BACKGROUND
  Intertrochanteric fracture is one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to low-energy trauma like simple falls. Dynamic Hip Screw (DHS) is still considered the gold standard for treating intertrochanteric fractures by many. Not many studies compare the DHS with Proximal femoral nail (PFN), in Type II intertrochanteric fractures (Boyd and Griffin classification). This study was done to compare the functional and radiological outcome of PFN with DHS in treatment of Type II intertrochanteric fractures.
  
  
  METHODS
  From October 2012 to March 2015, a prospective comparative study was done where 30 alternative cases of type II intertrochanteric fractures of hip were operated using PFN or DHS. Intraoperative complications were noted. Functional outcome was assessed using Harris Hip Score and radiological findings were compared at 3, 6, and 12 months postoperatively.
  
  
  RESULTS
  The average age of the patients was 60 years. In our series we found that patients with DHS had increased intraoperative blood loss (159ml), longer duration of surgery (105min), and required longer time for mobilization while patients who underwent PFN had lower intraoperative blood loss (73ml), shorter duration of surgery (91min), and allowed early mobilization. The average limb shortening in DHS group was 9.33 mm as compared with PFN group which was only 4.72 mm. The patients treated with PFN started early ambulation as they had better Harris Hip Score in the early post-op period. At the end of 12th month, there was not much difference in the functional outcome between the two groups.
  
  
  CONCLUSIONS
  PFN is better than DHS in type II intertrochanteric fractures in terms of decreased blood loss, reduced duration of surgery, early weight bearing and mobilization, reduced hospital stay, decreased risk of infection and decreased complications.
authors.affiliation: Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry, India.
authors.forename: Cyril
authors.initials: C
authors.lastname: Jonnes
authors.affiliation: Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry, India.
authors.forename: Shishir
authors.initials: S
authors.lastname: Sm
authors.affiliation: Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry, India.
authors.forename: Syed
authors.initials: S
authors.lastname: Najimudeen
keywords: Dynamic Hip Screw (DHS); Harris Hip Score; Intertrochanteric fractures; Proximal Femoral Nail (PFN)