Dhs vs pfn
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Dhs vs pfn

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Dhs vs pfn Dhs vs pfn Presentation Transcript

  • DHS PFN
  • ARTICLE  A PROSPECTIVE TRIAL OF PROXIMAL FEMORAL NAIL VERSUS DYNAMIC HIP SCREW FOR UNSTABLE AND COMPLEX INTERTROCHANTERIC FRACTURES OF THE FEMUR  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 groups  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.
  • ARTICLE  Treatment Of Unstable Intertrochanteric Fractures:A Comparison Between Dhs And Pfn  Trauma 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 30 minute  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 DHS group
  •  There was not a significant difference in the union time, postoperative morbidities or mortalities.  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
  • ARTICLE  Unstable trochanteric femoral fractures: extramedullary or intramedullary fixation. Review of literature. Schipper IB, Marti RK, van der Werken C.  COCHARANE REVIEW
  •  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.
  • ARTICLE  Stabilisation of unstable trochanteric femoral fractures. Dynamic hip screw (DHS) with trochanteric stabilisation plate vs. proximal femur nail (PFN)  Author(s)  NUBER S. (1) ; SCHÖNWEISS T. (1) ; RÜTER A.  Springer, Heidelberg, ALLEMAGNE
  •  significantly shorter operation time (44.3 vs. 57.3 min)  a considerably shorter in-patient stay (18.6 vs.21.3 days)  full-weight-bearing immediately after the operation was possible for 97% of the PFN patients and 88% of the DHS patients
  •  CONCLUSION  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.
  • ARTICLE  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
  • ARTICLE  J Orthop Surg (Hong Kong). 2007 Dec;15(3):278-81  Intramedullary nailing versus fixed angle blade plating for subtrochanteric femoral fractures: a prospective randomised controlled trial. 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  JournalInternational Orthopaedics 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
  • THANK YOU