Proximal Femoral Nail vs. Dynamic Condylar Screw in Unstable Intertrochanteric Fractures: A Randomized Comparative Study

Dr. Tej Pratap Khuteta, Dr. Devarsh Goyal, Dr. Vicky Kumar, Dr. Mrinal Jangid, Dr. Harshit Kumar

Abstract: Background: Unstable intertrochanteric femoral fractures are common in the elderly and associated with significant morbidity. This study compares the clinical, radiological, and functional outcomes of Proximal Femoral Nail (PFN) and Dynamic Condylar Screw (DCS) fixation in managing these fractures. Methods: A prospective, randomized, controlled study was conducted in the Department of Orthopaedics, S.M.S. Medical College, Jaipur, from January to December 2024. Sixty adult patients (>18 years) with unstable intertrochanteric fractures were equally divided into two groups: Group A (DCS, n=30) and Group B (PFN, n=30). Both groups underwent standardized surgical and rehabilitation protocols. Functional outcomes were assessed using the Harris Hip Score (HHS) and radiological union by the Radiographic Union Score for Hip (RUSH) at 2 weeks, 6 weeks, 3 months, and 6 months. Operative parameters, complications, and union rates were statistically analyzed. Results: The mean age was 72.3 years, with comparable demographics between groups. PFN demonstrated significantly shorter operative time (64.8 ± 7.9 vs. 112.7 ± 11.1 min; p<0.001) and lower intraoperative blood loss (116.3 ± 36.1 vs. 281.6 ± 84.1 mL; p<0.001). Radiological and functional outcomes improved steadily in both groups, with PFN showing slightly higher mean RUSH (28.9 ± 2.05 vs. 27.5 ± 3.83) and HHS (83.7 ± 8.0 vs. 82.6 ± 9.8) at six months, though not statistically significant. Union rates were 90% for PFN and 80% for DCS (p=0.278). Complications, including implant failure and infection, were comparable. Conclusion: Both PFN and DCS provide satisfactory results; however, PFN offers notable intraoperative advantages with less blood loss, shorter surgery time, and a trend toward faster union, making it the preferred option for unstable intertrochanteric fractures in elderly patients.

Keywords: Proximal femoral nail, Dynamic condylar screw, Intertrochanteric fracture, Harris Hip Score, RUSH score

How to Cite?: Dr. Tej Pratap Khuteta, Dr. Devarsh Goyal, Dr. Vicky Kumar, Dr. Mrinal Jangid, Dr. Harshit Kumar, "Proximal Femoral Nail vs. Dynamic Condylar Screw in Unstable Intertrochanteric Fractures: A Randomized Comparative Study", Volume 15 Issue 1, January 2026, International Journal of Science and Research (IJSR), Pages: 256-262, https://www.ijsr.net/getabstract.php?paperid=SR26104202210, DOI: https://dx.doi.org/10.21275/SR26104202210