Comparative Analysis of Proximal Femoral Nail and Dynamic Hip Screw Fixation in Intertrochanteric Fractures: Impact on Stability and Functional Outcomes

Background: Intertrochanteric fractures are prevalent injuries, particularly among individuals over sixty, and are often associated with osteoporotic women.The goal of modern surgical management is to expedite patient recovery while minimizing complications.This study aims to evaluate and compare functional outcomes following treatment of peritrochanteric femur fractures using Dynamic Hip Screw (DHS) and Proximal Femoral Nail (PFN) techniques.Methods: A prospective comparative study was conducted at Index Medical College Hospital and Research Centre, Indore, involving 80 adult patients with hip fractures.Patients were randomly assigned to receive either DHS or PFN treatment.Clinical data were collected, including surgical time, blood loss, and complications, and functional outcomes were assessed using the Harris Hip Score (HHS) over six months. Results:The study included 49 males (61.3%) and 31 females (38.8%), with the majority aged 61-70 years.Surgical times were significantly longer for DHS (140.43 minutes) compared to PFN (94.93 minutes) (p < 0.001).Additionally, intraoperative blood loss was higher in the DHS group (223.88 ml) compared to the PFN group (114.28 ml) (p < 0.001).The PFN group exhibited superior improvements in HHS at multiple time points (p < 0.001).Complication rates were higher in the DHS group, particularly regarding pain in the lateral thigh region (p = 0.042). Conclusion:Both DHS and PFN techniques yield comparable outcomes for stable intertrochanteric fractures, but PFN shows advantages in unstable fractures by promoting faster recovery and reducing complications.Overall, PFN is recommended as a superior fixation device for intertrochanteric fractures.