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Study of Management of Intertrochanteric Fractures of Femur in Adults by Various Surgical Modalities

Srinivas Bachu, Associate Professor, Dept. of Orthopaedics, Govt. Medical College, Nizamabad, Telangana 503001, India , Venugopal Palakurthi1 , Srinivas Bachu2

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Journal of Orthopedic Education 4(2):p 81-88, May - August 2018. | DOI: DOI: http://dx.doi.org/10.21088/joe.2454.7956.4218.7

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Abstract

 Aim: To study the outcome of the various surgical modalities (DHS, PFN, Cemented bipolar arthroplasty) in the management of intertrochanteric fractures of femur in adults, compare the results, in various age groups, asses the complications encountered with each method. Materials and Methods: The present study consists of 50 adult patients with intertrochanteric fractures of femur treated with DHS, PFN and cemented bipolar prosthesis at department of Orthopaedics. Results: In this study of 50 patients, 14 were treated with PFN, 20 with DHS, 15 with bipolar hemiarthroplasty and 1 with other method. Intertrochanteric fractures common between 29-48 years and 49-78 years, shows bimodal age distribution. In young patients it was due to high velocity trauma, fall from height being the common mechanism of injury. Slip and fall was common mechanism in elderly. It was more common in females due to post menopausal osteoporosis. Associated injuries were more common in high velocity trauma. Early surgery increases patients comfort, facilitates nursing care, helps in early mobilization of patients and decreases hospital stay. Conclusion: In elderly patient with osteoporotic communited IT fracture, bipolar hemiarthroplasty is better option, Unstable, communited and reverse oblique IT fracture with good bone quality PFN is a better option. DHS is the still viable option in stable fractures and in unstable fracture with technical expertise, in improving fracture stability. 

Keywords: DHS; PFN; Cemented Bipolar Arthroplasty.

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DOI: DOI: http://dx.doi.org/10.21088/joe.2454.7956.4218.7

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