Comparative Evaluation Of Proximal Femoral Nail And Dynamic Condylar Screw Fixation In Subtrochanteric Femur Fractures: A Prospective Study

Abstract

Background:Subtrochanteric femur fractures pose a significant surgical challenge due to their high biomechanical stress and limited healing potential. This study compared clinical, radiological, and functional outcomes between Proximal Femoral Nail (PFN) and Dynamic Condylar Screw (DCS) fixation in such fractures.

Methods:A prospective comparative study was conducted involving 60 patients with subtrochanteric fractures, treated with either PFN (n = 30) or DCS (n = 30). Variables including demographics, fracture type, surgical parameters, complications, union time, and functional outcomes (Harris Hip Score, hip range of motion at 12 months) were analyzed.

Results:The PFN group had significantly shorter operative time (94.33 ± 21.72 min vs. 114.00 ± 14.76 min; p < 0.0001), lower intraoperative blood loss (107.50 ± 19.86 ml vs. 234.17 ± 62.80 ml; p < 0.0001), and earlier fracture union (13.21 ± 2.90 weeks vs. 19.97 ± 3.93 weeks; p < 0.0001). Full weight bearing was achieved sooner in the PFN group (14.54 ± 2.74 weeks vs. 21.67 ± 2.98 weeks; p < 0.0001). Functional outcomes were superior in the PFN group, with higher Harris Hip Scores (85.5 ± 7.62 vs. 80.2 ± 7.14; p = 0.0073) and greater range of motion.

Conclusion:PFN demonstrated clear advantages over DCS in terms of surgical efficiency, faster fracture healing, earlier mobilization, and improved functional recovery. It may be preferred, particularly in elderly or high-risk patients.