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Abstract Objective: To compare the results of operative management using two different kind of internal fixation modality devices either PFN or DHS, to achieve fracture union and to determine the rate of union, complications, operative risks and functional recovery and outcomes. Compare the results obtained and determine the effectiveness of PFN in comparison to DHS in treatment of intertrochanteric fractures. Introduction: Intertrochanteric fractures form about 50% of all fractures that occur in proximal part of femur. The mean patient age is 66 to 76 years. In United States of America, the rate of intertrochanteric fractures in elderly men is about 34 per 100,000 and in women it is 63 per 100,000 annually. Intertrochanteric fractures mostly unite, provided that reduction and fixation are correctly done. There are large area of bone is involved, mostly consist of cancellous bone and both fragments are richly supplied by blood. Determination of stability is the most important aspect of intertrochanteric fracture classification. Stability is provided by an intact or a reconstructible posteromedial buttress. Reverse obliquity fractures, loss or comminution of the posteromedial buttress and subtrochanteric extension are factors that results in unstable fracture patterns. Management The treatment goal of intertrochanteric fracture is restoration of early mobility safely and adequately while decreasing the hazard of medical complications and technical failure and to restore the patient to preoperative status of function. Trochentric femoral fracures have been estimated to occur in more than 200,000 patients annually in the United States, with reported mortality rate from 15 %to 30%. Study design: Randomized controlled trials and quasi-random studies. Key words: Unstable/intertrochanteric/DHS/TSP/gamma nail. |