Dynamic hip screw versus proximal femoral nailing in stable intertrochanteric fractures: a systematic review of efficacy and outcomes
Abstract Background Stable intertrochanteric fractures of the hip are common injuries, particularly among the elderly population. Effective surgical intervention is crucial for improving patient outcomes and recovery. Two widely used fixation techniques are the Dynamic Hip Screw (DHS) and Proximal F...
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BMC
2025-07-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-025-09005-z |
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| author | Asim Hatim Mohammed Musa Mohamed Suhaib Ali Mohamed Hiba Gamareldin A. KhalafAllah Mohammed Mubarak Mohammed Ahmed Mahgoub Hamed Ahmed Fadlalla Sara Gamareldein A. Khalafalla Mohammed Hammad Jaber Amin Hozifa Mohammed Ali Abdelmaged |
| author_facet | Asim Hatim Mohammed Musa Mohamed Suhaib Ali Mohamed Hiba Gamareldin A. KhalafAllah Mohammed Mubarak Mohammed Ahmed Mahgoub Hamed Ahmed Fadlalla Sara Gamareldein A. Khalafalla Mohammed Hammad Jaber Amin Hozifa Mohammed Ali Abdelmaged |
| author_sort | Asim Hatim Mohammed Musa |
| collection | DOAJ |
| description | Abstract Background Stable intertrochanteric fractures of the hip are common injuries, particularly among the elderly population. Effective surgical intervention is crucial for improving patient outcomes and recovery. Two widely used fixation techniques are the Dynamic Hip Screw (DHS) and Proximal Femoral Nailing (PFN). Both methods aim to provide stability and help early mobilization, yet they differ in their biomechanical properties and clinical implications. Objective This review article aims to compare the efficacy and outcomes of DHS and PFN in the treatment of stable intertrochanteric fractures, focusing on key metrics such as the Harris Hip Score (HHS), pain management, functional recovery, and complication rates. By synthesizing findings from recent studies, the review seeks to provide a comprehensive understanding of the advantages and limitations of each technique. Results Comparative analysis demonstrated that proximal femoral nailing (PFN) was associated with shorter hospital stays (average: 7.8 days compared to 12.4 days), earlier mobilization (7.93 weeks compared to 11.80 weeks to full weight-bearing), and better early postoperative functional results (Harris Hip Scores: 90.33 compared to 89.08 at the 12-month follow-up) compared to dynamic hip screw (DHS). However, PFN was associated with a longer fluoroscopy exposure and higher rates of implant cut-out complications, whereas DHS was associated with higher intraoperative risks of lateral wall fractures (32% rate), higher blood loss, and reoperation rates. Economic evaluation revealed comparable overall costs for both modalities, although the initial implantation costs were greater for PFN. Fracture union timelines were statistically comparable (mean: ~130 days). Conclusion The diagnosis and management of intertrochanteric fractures remain a subject of considerable debate, both techniques have their distinct sets of benefits and drawbacks, highlighting the necessity for a tailored approach depending on patient-specific factors and surgical settings. Ultimately, these multifaceted findings underscore the need for further comparative studies to better understand these differences and aid in improving surgical approaches for intertrochanteric fractures. This will enable more informed decision-making, potentially improving patient outcomes and optimizing resource use in healthcare settings. |
| format | Article |
| id | doaj-art-bfa5917d61d644988c9a72d03263f01f |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-bfa5917d61d644988c9a72d03263f01f2025-08-20T04:01:42ZengBMCBMC Musculoskeletal Disorders1471-24742025-07-0126111110.1186/s12891-025-09005-zDynamic hip screw versus proximal femoral nailing in stable intertrochanteric fractures: a systematic review of efficacy and outcomesAsim Hatim Mohammed Musa0Mohamed Suhaib Ali Mohamed1Hiba Gamareldin A. KhalafAllah2Mohammed Mubarak Mohammed Ahmed3Mahgoub Hamed Ahmed Fadlalla4Sara Gamareldein A. Khalafalla5Mohammed Hammad Jaber Amin6Hozifa Mohammed Ali Abdelmaged7Faculty of Medicine, Alzaiem Alazhari UniversityFaculty of Medicine, Alzaiem Alazhari UniversityFaculty of Medicine, University of GeziraOrthopedic Department, Ibrahiem Malik Teaching HospitalRibat Teaching HospitalSpecialist of Pediatric and Child Health, MAH pediatric HospitalFaculty of Medicine, Alzaiem Alazhari UniversityOrthopedic Department, Alzaiem Alazhari UniversityAbstract Background Stable intertrochanteric fractures of the hip are common injuries, particularly among the elderly population. Effective surgical intervention is crucial for improving patient outcomes and recovery. Two widely used fixation techniques are the Dynamic Hip Screw (DHS) and Proximal Femoral Nailing (PFN). Both methods aim to provide stability and help early mobilization, yet they differ in their biomechanical properties and clinical implications. Objective This review article aims to compare the efficacy and outcomes of DHS and PFN in the treatment of stable intertrochanteric fractures, focusing on key metrics such as the Harris Hip Score (HHS), pain management, functional recovery, and complication rates. By synthesizing findings from recent studies, the review seeks to provide a comprehensive understanding of the advantages and limitations of each technique. Results Comparative analysis demonstrated that proximal femoral nailing (PFN) was associated with shorter hospital stays (average: 7.8 days compared to 12.4 days), earlier mobilization (7.93 weeks compared to 11.80 weeks to full weight-bearing), and better early postoperative functional results (Harris Hip Scores: 90.33 compared to 89.08 at the 12-month follow-up) compared to dynamic hip screw (DHS). However, PFN was associated with a longer fluoroscopy exposure and higher rates of implant cut-out complications, whereas DHS was associated with higher intraoperative risks of lateral wall fractures (32% rate), higher blood loss, and reoperation rates. Economic evaluation revealed comparable overall costs for both modalities, although the initial implantation costs were greater for PFN. Fracture union timelines were statistically comparable (mean: ~130 days). Conclusion The diagnosis and management of intertrochanteric fractures remain a subject of considerable debate, both techniques have their distinct sets of benefits and drawbacks, highlighting the necessity for a tailored approach depending on patient-specific factors and surgical settings. Ultimately, these multifaceted findings underscore the need for further comparative studies to better understand these differences and aid in improving surgical approaches for intertrochanteric fractures. This will enable more informed decision-making, potentially improving patient outcomes and optimizing resource use in healthcare settings.https://doi.org/10.1186/s12891-025-09005-zIntertrochanteric fracturesSide plateIntramedullary devicePFNPFNAGamma nail |
| spellingShingle | Asim Hatim Mohammed Musa Mohamed Suhaib Ali Mohamed Hiba Gamareldin A. KhalafAllah Mohammed Mubarak Mohammed Ahmed Mahgoub Hamed Ahmed Fadlalla Sara Gamareldein A. Khalafalla Mohammed Hammad Jaber Amin Hozifa Mohammed Ali Abdelmaged Dynamic hip screw versus proximal femoral nailing in stable intertrochanteric fractures: a systematic review of efficacy and outcomes BMC Musculoskeletal Disorders Intertrochanteric fractures Side plate Intramedullary device PFN PFNA Gamma nail |
| title | Dynamic hip screw versus proximal femoral nailing in stable intertrochanteric fractures: a systematic review of efficacy and outcomes |
| title_full | Dynamic hip screw versus proximal femoral nailing in stable intertrochanteric fractures: a systematic review of efficacy and outcomes |
| title_fullStr | Dynamic hip screw versus proximal femoral nailing in stable intertrochanteric fractures: a systematic review of efficacy and outcomes |
| title_full_unstemmed | Dynamic hip screw versus proximal femoral nailing in stable intertrochanteric fractures: a systematic review of efficacy and outcomes |
| title_short | Dynamic hip screw versus proximal femoral nailing in stable intertrochanteric fractures: a systematic review of efficacy and outcomes |
| title_sort | dynamic hip screw versus proximal femoral nailing in stable intertrochanteric fractures a systematic review of efficacy and outcomes |
| topic | Intertrochanteric fractures Side plate Intramedullary device PFN PFNA Gamma nail |
| url | https://doi.org/10.1186/s12891-025-09005-z |
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