Comparative Bony Union Time Analysis of Dynamic Hip Screw and Proximal Femoral Plate Implants

Abstract

Objective: To determine the comparative and effective applicability of the Dynamic Hip Screw (DHS), and proximal femoral plate (PFP) in terms of the rapid bony union and complications for treating unstable pertrochanteric fractures.

Methodology: This comparative study was conducted at the Department of Orthopedic surgery, Pakistan Institute of Medical Sciences, Islamabad during a period of 8 months from August 2016 to April 2017. Patients ages of 45 to 90 years, with close fresh unstable pertrochanteric fractures (one week) and of either gender were included. All the patients were divided into two groups. Patients in group A underwent PFP treatment and patients of group B underwent DHS treatment. Patients were followed up after 6 weeks and then every 2 weekly afterwards for a total period of 3 months for assessment of bony union both clinically and radiologically. The data was collected on a pre-structured Performa, and analysis was done using SPSS version 26.

Results: A total of 84 patients were analysed, and average age of the patients in the PFP group was 66.57 ± 11.71 years and in the DHS group was 70.14 ± 9.03 years. Females were found in majority in both groups. No union was found till six weeks in both groups, while on 2nd month followup, union was found significantly high 19.0% in cases of the PFP group, compared to the 2.4% in the DHS group (p-0.014). On 2.5th months the union rate was significantly higher 59.5% in the PFP group, compared to the 7.1% DHS group (p-0.014), while on the 3^rd month followup the union was almost in all cases in both groups (p-0.557) and the overall average union duration was significantly lower in PFP group compared to the DHS (p-0.001).

Conclusion: The proximal femoral plate technique for treating unstable pertrochanteric fractures was observed to be more effective in terms of significant rapid bony union with minimum complications compared to the Dynamic Hip Screw (DHS).