COMPARISON OF DYNAMIC HIP SCREW (DHS) VS PROXIMAL FEMORAL NAIL ANTI ROTATION (PFNA) IN STABLE INTERTROCHANTERIC (IT) FRACTURE

Abstract

Objective:- To compare the outcomes of dynamic hip screw (DHS) versus proximal femoral nail antirotation (PFNA) in stable intertrochanteric fractures.

Study Design:-  A quasi-experimental study.

Study Place and Duration:- Department of Orthopedic Surgery, Dow University Hospital, Ojha Campus, Karachi,  during January 2026 and May 2026 allowing a minimum follow-up of three months postoperatively.

Methodology:- A quasi-experimental study was conducted on 60 patients aged 18–80 years with stable intertrochanteric fractures, divided equally into PFNA and DHS groups. Operative time, intraoperative blood loss, hospital stay, surgical site infection, fracture union, and functional outcome using Harris Hip Score (HHS) were assessed. Data were analyzed using SPSS version 20, with p ≤0.05 considered significant.

Results: The PFNA group demonstrated significantly shorter operative time (53.77±3.04 vs. 77.67±7.60 minutes; p<0.001) and lower intraoperative blood loss (241.03±26.57 vs. 446.53±32.23 ml; p<0.001) compared to the DHS group. Hospital stay was shorter in the PFNA group but not statistically significant (p=0.058). The DHS group showed significantly higher HHS at six months (89.93±3.53 vs. 83.17±3.59; p<0.001). No significant differences were observed in surgical site infection, fracture union, or overall functional outcome categories.

Conclusion: PFNA offers superior intraoperative efficiency with reduced operative time and blood loss, whereas DHS provides better functional outcomes in stable intertrochanteric fractures. Implant selection should be individualized based on patient and clinical factors.