Intertrochantric fractures (IT) are most frequently encountered in orthopaedic practice, but they pose big challenge in as far as treatment is considered. DHS has been the gold standard for operative management of this fracture. But recently PFN has been used extensively in various Centre. The purpose of this study is to compare the surgical and functional outcome of the patients treated with PFN and DHS and to determine their advantages and disadvantages. Methods-A prospective study of 40 patients with IT fractures of type 1 to 3 Boyd and Griffin at our institute. They were treated either with PFN or DHS. Patients were evaluated by various criteria like time for full weight bearing, union time, deformity, shortening, pain disability and were assessed by Harris hip score system. Plain AP and Lateral Radiographs of pelvis and both hips were obtained for every patients. Minimum follow up was done at 3 months and result were assesses by using Harris hip score system and Radiographs at final follow up. Result: Excellent-good clinical outcome was obtained in 80% of patients treated with DHS and PFN. Early rehabilitation and early return to work was more possible in patients. There was one case of varus deformity and one case of shortening in PFN group and 2 cases of varus deformity and 3 case of shortening in DHS group. There were 2 cases with reverse Z effect in PFN group. Post-operative infection developed in 4 patients (2 in each group). Superficial wound infection was seen in 3 cases in total of which 1 case in PFN group while 2 cases in DHS group. There was less blood loss in PFN group. Conclusion: Duration of hospital stay is significantly reduced amongst the patients operated by PFN compared with DHS and rehabilitation was also faster by starting earlier sitting and thereby reducing morbidity and burden to hospital. Consequent earlier return to normal routine life can be expected. Although overall outcome of the patients at final follow up remains almost same. Less exposure and less blood loss due to closed procedure does help in rehabilitation of the patients, fasten the recovery and thereby reducing psychiatric problems related to it.
