Functional outcome of pertrochanteric fractures undergoing Dynamic Hip Screw versus Proximal Femoral Nail Anti-Rotation Techniques at a Tertiary care hospital of Karachi.

Abstract

Objective: To find out the functional outcomes as per Harris hip score (HHS) among patients of pertrochanteric fractures undergoing dynamic hip screw (DHS) versus proximal femoral nail anti-rotation (PFNA) at a Tertiary care hospital. Study Design: Non-randomized Controlled Trial. Setting: Orthopedic Section, Department of Surgery, Agha Khan University Hospital, Karachi, Pakistan. Period: 1^st August 2023 to 30^th January 2023. Methods: A total of 40 patients of age 18 and older with confirmed pertrochanteric fractures were non-randomly allocated to ether fixation with DHS or PFNA. Intra-opeative blood loss and duration of surgery were recorded. The functional outcome assessment was assessed using HHS. Results: In a total of 40 patients, 31 (77.5%) were female. The mean age was 67.63±15.13 years (ranging between 23 to 89 years). The most common mechanism of fall was tipped over loose carpet, noted in 17 (42.5%) patients.  The mean intra-operative blood loss in DHS and PFNA groups were 73.75±20.06 ml, and 72.75±23.14 ml, respectively (p=0.885). The mean duration of surgery were 76.6±14.7 minutes, and 115.1±18.3 minutes in DHS and PFNA groups, respectively (p<0.001). Excellent, good, fair, poor, and failed outcomes were reported in 3 (7.5%), 17 (42.5%), 6 (15.0%), 10 (25.0%), and 4 (10.0%) patients respectively. When both groups were compared for outcomes, no statistically significant differences were observed (p=0.339). The mean HHS in DHS, and PFNA groups were 75.26±11.41, and 73.46±14.57, respectively (p=0.666). Conclusion: Functional outcomes as per HHS were relatively similar with DHS and PFNA approaches in patients with pertrochanteric fractures.