INTRODUCTION:The incidence of fracture around hip has increased a lot
with gradual increase in general life expectancy of the population. The
fracture around hip accounts for about one third of all hospitalized patients.
Among the different type of fractures around hip extracapsular fracture of
proximal end femur are most common. The incidence is more than the fracture
femoral neck proper. In elderly, 90% of extracapsular fracture results from
trivial injury while in young adult it results from high energy trauma like
motor vehicle accident. The incidence of extracapsular fracture in elderly is
more than fracture in young adult because of several factors like osteoporosis,
decreased muscle power, poor vision. These fractures are associated with a
substantial morbidity and mortality and account for a large amount of
expenditure in the treatment. Now days mode of treatment is changing from
conservative to surgical, so it need to study different treatment modality
forextracapsular fracture ofproximal femur. AIM AND OBJECTIVE:To assess and
evaluate different surgicalmodality of management in extracapsular fracture of
proximal femur. MATERIAL AND METHOD:This was prospective analytic study,
conducted at the Department of Orthopaedics and Traumatology, D.M.C.H., Laheriasarai,
Darbhanga in year 2007 to 2010. Total 32 Cases were selected by inclusion and
exclusion criteria. Out of 32 cases, 12 cases were treated with PFN and 20 with
DHS. All the operations were done under image intensifier control. Follow up of
the patients were done up to 48th postoperative weeks for the assessment of
functional and anatomical result. OBSERVATION AND RESULT:Present series is of
32 cases, of it 43.75% were male and 56.25% were female, Average age was 50-70
years. Most common mode of injury was trivial injury/minor slip comprising
46.87% patients in which 31.25% female and 15.62% male. Second commonest mode
of injury was Road Traffic accident comprising 25%, in which 15.62% were male
and 9.37% were female. The # was classified by EVAN’S classification, 59.37%
cases were of stable fracture, 28.12 of unstable type and 12.50% were
subtrochanteric type fracture. # were reduced under image intensifier and fixed
with D.H.S or P.F.N. by 3rd postoperative weeks, in PFN group 91.66% of cases
were partial weight bearing with crutches, But in DHS group by 6th
postoperative weeks 75% of cases partial weight bearing with help of crutches,
full weight bearing in P.F.N group was 12-18 wk and in D.H.S group it was 18-24
wk. 8% in P.F.N group and 15% in D.H.S group had superficial infection while
10% in D.H.S group had deep infection, no deep infection in P.F.N group.
CONCLUSION:In PFN group patients, blood loss and soft tissue dissection was
less as compared to DHS group patients.Within first 3 months PFN allowed a
faster postoperative restoration of walking ability as compared to DHS. It was
found that there was no major difference between PFN and DHS treatment group
long term follow-up in clinical and radiological features. - See more at:
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