A PROSPECTIVE TRIAL OF PROXIMAL
FEMORAL NAIL VERSUS DYNAMIC HIP
SCREW FOR UNSTABLE AND COMPLEX
INTERTROCHANTERIC FRACTURES OF
Arshad Bhatti; Dominic Power; Sohail
Qureshi; Ishrat Khan; and Simon Tan
Journal of Bone and Joint Surgery - British
Volume, Vol 86-B, Issue SUPP_III, 377
Operation duration was similar in the two
blood loss was significantly less in the PFN
group (PFN 275mls; DHS 475mls)
significant difference in length of hospital
stay (PFN 14 days; DHS 22 days)
DHS group suffered failure of fixation, two of
them had screw cut out.
no implant failures or failure of the PFN gr
At 6 months both groups showed similar mobility.
Persistent severe hip pain at 6 months was PFN 3%
and DHS 9%.
Conclusion: The proximal femoral nail may be used
successfully in the fixation of unstable femoral
fractures with similar results to the DHS for mobility
at 6 months. There may be advantages over the
DHS in terms of reduced blood loss, shorter hospital
stay and less morbidity.
Treatment Of Unstable Intertrochanteric
Fractures:A Comparison Between Dhs
Kee-Byung Lee, MD Anyang Korea,
Republic of (n)
Yong-Woon Shin, MD Anyang Korea,
Republic of (n)
The mean duration of operation was shorter
in PFN group compared with DHS group by
The amount of transfusion was 2.1 unit for
DHS group and 1.7 units for PFN group
loss of reduction that occurred in one hip in
There was not a significant difference in the
union time, postoperative morbidities or
The mobility score was higher in PFN group
than in DHS group though social function
score was similar.
concluded that the use of PFN has
advantage in shorter operative time and
better mobility of the patients while not
altering overall course of patients' recovery
Unstable trochanteric femoral fractures:
extramedullary or intramedullary fixation.
Review of literature.
Schipper IB, Marti RK, van der Werken C.
For unstable fractures intramedullary
implants are (biomechanically) superior. The
review shows that clinical advantages of both
treatment methods are suggested and
advocated, but still remain to be
demonstrated on evidence base.
Stabilisation of unstable trochanteric femoral
fractures. Dynamic hip screw (DHS) with
trochanteric stabilisation plate vs. proximal
femur nail (PFN)
NUBER S. (1) ; SCHÖNWEISS T. (1) ;
Springer, Heidelberg, ALLEMAGNE
significantly shorter operation time (44.3 vs.
a considerably shorter in-patient stay (18.6
full-weight-bearing immediately after the
operation was possible for 97% of the PFN
patients and 88% of the DHS patients
Unstable pertrochanteric and per-
/subtrochanteric femoral comminuted
fractures can be treated just as well with PFN
as with DHS.The study results, however, lead
us to recommend treatment with PFN.
Pertrochanteric fractures: is there an
advantage to an intramedullary nail?: a
randomized, prospective study of 206
patients comparing the dynamic hip screw
and proximal femoral nail. [Clinical Trial,
Journal Article, Randomized Controlled Trial]
Orthop Trauma 2002 Jul; 16(6):386-93.
There is no advantage to an intramedullary
nail versus a sliding compression hip screw
for low-energy pertrochanteric fractures
J Orthop Surg (Hong Kong). 2007
Intramedullary nailing versus fixed angle
blade plating for subtrochanteric femoral
fractures: a prospective randomised
Rahme DM, Harris IA.
RESULTS: There were no significant differences
between the 2 groups with regard to age, time to
surgery, operating time, receipt of blood
transfusions, duration of hospital stay, or fracture
classification. The revision rate was 28% (8/29) in
the BP group and none in the IN group.
CONCLUSION: Internal fixation using a fixed angle
blade plate for subtrochanteric femoral fractures has
higher implant failure and revision rates, compared
to closed intramedullary nailing.
Proximal femoral nail – an analysis of 100 cases
of proximal femoral fractures with an average
follow up of 1 year
Osteosynthesis with the PFN offers the advantages of
high rotational stability of the head-neck fragment,
an unreamed implantation technique and the
possibility of static or dynamic distal locking