Comparative study of Extramedullary and Intramedullary devices in management of Subtrochanteric femoral fractures

Introduction: Subtrochanteric fractures result from high energy trauma in young patients and most cases are associated with multiple injuries. In elderly patients, this fracture is often caused by low energy trauma because of osteoporosis and Surgical treatment is the preferred method for subtrochanteric femoral fracture and two main categories of implants are used which are Extra medullary and Intramedullary. Aims and Objective: To study the outcome of subtrochanteric hip fractures treated with extra medullary & intramedullary devices. Materials and Methods: Sixty patients with subtrochanteric fractures were divided into two groups. Thirty patients in group A & thirty patients in group B. Group A was treated with intra medullary device (PFN) and group B was treated with extra medullary device (DCS). Follow-up was done at 6 weeks, 3 months, 6 months, 9 months and 12 months post operatively for clinico-radiological assessment. Results: In Group A (PFN), Excellent results were seen in 47% of cases, good in 40% of cases and fair in 12% of cases with lesser duration of surgery and blood loss. In group B (DCS), excellent results were seen in 33% of cases, good in 27% of cases and fair in 40% of cases. Conclusion: Intramedullary devices used in Subtrochanteric femur fractures has high rates of union, minimal soft-tissue damage, minimal blood loss, lesser hospital stay with biological and biomechanical advantage.