Comparative between proximal femoral lockingplate (PFLP) versus dynamic hip screw (DHS)forstable intertrochanteric femoral fractures,two years cohort study, Sisaket Hospital
Keywords:
intertrochanteric femoral fractures, proximal femoral locking plate, dynamic hip screwAbstract
Background: Intertrochanteric fracture due to osteoporosis is a major public healthproblem. Treatment is both surgical and non-surgical. The most popular and standard surgicalprocedure is dynamic hip screw fixation. However, this implant has also been reported to causemany complications. Other forms of bone fixation have been developed to treat intertrochantericfracture. The use of proximal femoral locking plate is one of them. However, the treatmenteffect in stable intertrochanteric fracture compared to the current dynamic hips screw is stillunclear.
Objective: To compare the outcome of stable intertrochanteric fracture treatment between proximal femoral locking plate and dynamic hip screw in Sisaket Hospital
Materials and Methods: This retrospective study was carried out on patients who wereadmitted to Sisaket Hospital with stable intertrochanteric fractures of femur from 1st January 2015 – 31st Dec 2016. Medical records and postoperative radiographs of patients treatedwith either the DHS or PFLP devices were used to compare the results of surgical treatment.Analytic statistics were Chi square and Fisher’s Exact probability test, for continuous variablesusing independent student t-test and statistically significant at p-value <0.05.
Results: Stable intertrochanteric fracture who undergone these surgical treatment were95 cases, 59 patients treated with dynamic hip screws (DHS) and 36 patients treated withproximal femoral locking plate (PFLP). Patients treated with the DHS device had shorter operative time, lower intra-operative blood loss and amount of blood from radivac drain andshorter hospital stay than those treated withPFLP devicewith statistically significant (p value<0.001,0.004,0.015 and 0.042 respectively). Furthermore, patients treated with the DHS devicehad slightly shorter healing time, higher Harris Hip Scores at 1 and 3 months than those treatedwith PFLP device, but had no statistically significant.
Conclusions: When compare with proximal femoral locking plate, use of the DHS device remains the preferred treatment for stable intertrochanteric fractures.
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