Introduction: Fractures of the proximal femur are a big challenge in traumatology. Trochanteric fractures of the femur are rising in incidence. By definition pertrochanteric fractures are those occurring in the region extending from the extracapsular basilar neck to the region along the lesser trocchanter before the development of the medullary canal. Intertrochanteric and peritrochanteric are generic terms for pertrochanteric fractures.
Material and Methods: This is a Randomized and prospective study. All the patients with unstable intertrochanteric fracture femur, presenting to the Orthopedic Department of K.S.Hegde Charitable hospital from October 2011 to October 2013 are included in the study after explaining the procedure and getting the consent. 30 patients meeting the criteria are included for the present study and are randomized equally into two groups: 15 DHS cases and 15 PF- LCP. The study follow up requires evaluation at discharge, 6 weeks 3 months and 6 months. Patient information, including age and sex, nature of violence, type of fracture, associated injuries, operative treatment including and length of hospital stay will be recorded for each patient.
Results: In our series of 30 patients 4 patients expired due to associated medical problems. Functional outcome was assessed by taking the remaining 26 patients into consideration of which 14 patients were from DHS group and 12 patients from PF-LCP group. Among the 15 patients operated by PF-LCP, 8(53.3%) patients were found to have intertrochanteric fractures on the left side while 7(46.7%) patients were found to have fracture on the right side. Among the 15 patients operated by DHS, 3(20%) patients were found to have intertrochanteric fractures on the left side while 12(80%) patients were found to have fracture on the right side. In our present study we consider unstable intertrochanteric fractures Type2, Type 3 and Type 4 as classified by Boyd and Griffin We had 19(63.3%) patients of Type 2, 9(30%) patients of Type 3 and 2(6.67%) patients of Type 4 intertrochanteric fracture.
Conclusion: We conclude that DHS is a better alternative in unstable intertrochanteric fractures when compared to PF-LCP as the functional outcome was better and the complications were fewer in the DHS group when compared to PF-LCP group. The advantages of DHS being the ease and expertise with the procedure, the mechanism of sliding of the plate allowing the fracture to collapse into a stable configuration. PF- LCP being a complex system needs further understanding of the plate biomechanics.
