Edorium Journal of

Orthopedics

 
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Original Article
 
A prospective study to evaluate the outcome of operative treatment of patients with intertrochanteric fracture of femur with cephalomedullary nail and dynamic hip screw device
Riyaz N. N.1, Nithin S.2
1Associate Professor, Department of Orthopaedics, Academy of Medical Sciences, Pariyaram Medical College Hospital, Kannur-670503, Kerala; India.
2Resident, Department of Orthopaedics, Academy of Medical Sciences, Pariyaram Medical College Hospital, Kannur-670503, Kerala; India.

Article ID: 100001O03RN2015
doi:10.5348/O03-2015-1-OA-1

Address correspondence to:
Dr. Nithin S
MBBS, D. Ortho, Resident, Department of Orthopaedics, Academy of Medical Sciences
Pariyaram Medical College Hospital, Kannur-670503
Kerala
India
Phone: +91-9746090229
Fax: +91-9886389529

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How to cite this article
Riyaz NN, Nithin S. A prospective study to evaluate the outcome of operative treatment of patients with intertrochanteric fracture of femur with cephalomedullary nail and dynamic hip screw device. Edorium J Orthop 2015;1:1–7.


Abstract
Introduction: It is universally agreed that the treatment of intertrochanteric fractures is stable internal fixation as early as possible. Cephalomedullary nail is gaining popularity than dynamic hip screw over the last few years. The aim of this prospective study was to analyze the patient outcome after dynamic hip screw (DHS) and cephalomedullary nail (CMN) fixation.
Methods: The study was conducted in Yenepoya Medical College Hospital in Mangalore from 2007 to 2009. Study included 50 patients with intertrochanteric fractures treated with DHS and CMN. Sample size, 25 patients in each group were selected. Parameters compared include, duration of hospital stay, duration of surgery, fracture union, complications and functional outcome. DHS and CMN groups did not differ significantly with respect to age (p = 0.612), complication, pre and postoperative mobility score (p = 0.164), duration of union (p = 0.734) and functional outcome of the stable fractures. Patients with CMN required shorter incision (mean = 5.96 cm) when compared with DHS (mean = 14.04 cm). Surgical time with DHS was more (mean = 98.20 min) when compared with CMN (mean = 53.00 min). Patients treated with CMN experienced less postoperative pain when compared to DHS. Significantly less limb length shortening was seen with CMN (mean = 0.696 cm) as compared to DHS (mean = 1.016 cm). Patients in CMN group with unstable fracture shows better functional outcome when compared to patients with DHS.
Conclusion: In stable intertrochanteric fractures, both the CMN and DHS have similar outcomes and for unstable intertrochanteric fractures CMN have shown better functional outcome when compared to DHS.

Keywords: Cephalomedullary nail, Dynamic hip screw, Intertrochanteric fractures, Internal fixation, Proximal femoral nail

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Author Contributions:
Riyaz N. N. – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Nithin S. – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Riyaz N. N. et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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