Proximal Femoral Nailing versus 95° Dynamic Condylar Screw Fixation in Subtrochanteric Femoral Fractures A Comparative Study of 40 Cases
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Abstract
Background. Subtrochanteric femoral fractures present treatment challenges due to complex anatomy and biomechanical stressors. While PFN is associated with shorter surgical time and improved early mobility, DCS may still be the preferred option in specific fracture morphologies or resource-constrained settings like those in India. The objective of this study was to evaluate and compare the clinical, functional, and radiological outcomes of Proximal Femoral Nailing (PFN) versus the 95° Dynamic Condylar Screw (DCS).
Methodology. This prospective study was carried out between July 2023 and March 2025 at a tertiary care centre in India. Forty patients aged more than 18 years with closed subtrochanteric fractures were enrolled and randomized into PFN and DCS groups. Perioperative metrics (operation time, blood loss), postoperative pain (VAS), time to mobilization, union rate, complications, and functional outcomes (Harris Hip Score) were assessed at 6, 12, 24 weeks, and 1 year.
Results. Operative time (PFN: 53 ± 12.6 min vs. DCS: 75.6 ± 12.3 min, p <0.001) and intraoperative blood loss (PFN: 150.2 ± 20.4 ml vs. DCS: 197.1 ± 45.5 ml, p <0.001) were significantly lower in PFN. Pain scores at 48 hours were also significantly better in PFN (p = 0.005). Hospital stay was shorter in PFN (3 vs. 5.6 days, p <0.001) compared to DCS. At 12 months, both groups achieved 95% radiological union and comparable functional recovery (mean HHS = 92.8, p >0.05). Complications occurred infrequently and did not differ significantly.
Conclusions. PFN offers perioperative advantages without compromising functional or radiological outcomes, making it preferable in settings that prioritize faster recovery.
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References
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