Comparison of dynamic hip screw and proximal femoral nail in intertrochanteric femur fractures and cost analysis

Abstract

Purpose: The study was planned to compare the results of dynamic hip screw (DHS) and proximal femoral nailantirotation (PFNA) applications to femur intertrochanteric fractures and to implement a cost analysis.Materials and methods: A retrospective evaluaton was made of 75 patients who were treated for intertrochantericfemur fracture between May 2009 and December 2012. Evaluation was made of differences between the groupsin reduction quality, mean duration of hospitalization, complication rates, functional outcomes and treatmentcosts.Results: Thirty patients were treated with DHS and forty five patients with PFNA. The average follow-up periodwas 21.5 (12-49) months. Functional outcomes were similar, with no significant difference between the groups.Length of hospital stay was shorter in the PFNA group, the treatment and care costs were lower compared tothe DHS group.Conclusion: Although PFNA is a much more expensive implant than DHS, there is no significant differencebetween total hospital costs. Nevertheless, as DHS has similar functional results, it is still a preferrable treatmentmethod for intertrochanteric femur fractures.