Functional outcome of pertrochanteric fractures undergoing Dynamic Hip Screw versus Proximal Femoral Nail Anti-Rotation Techniques at a Tertiary care hospital of Karachi.


  • Pervaiz Hashmi Agha Khan University Hospital, Karachi, Pakistan.
  • Wajahat Alam Agha Khan University Hospital, Karachi, Pakistan.



Blood Loss, Dynamic Hip Screw, Harris Hip Score, Pertrochanteric Fractures, Proximal Femoral Nail


Objective: To find out the functional outcomes as per Harris hip score (HHS) among patients of pertrochanteric fractures undergoing dynamic hip screw (DHS) versus proximal femoral nail anti-rotation (PFNA) at a Tertiary care hospital. Study Design: Non-randomized Controlled Trial. Setting: Orthopedic Section, Department of Surgery, Agha Khan University Hospital, Karachi, Pakistan. Period: 1st August 2023 to 30th January 2023. Methods: A total of 40 patients of age 18 and older with confirmed pertrochanteric fractures were non-randomly allocated to ether fixation with DHS or PFNA. Intra-opeative blood loss and duration of surgery were recorded. The functional outcome assessment was assessed using HHS. Results: In a total of 40 patients, 31 (77.5%) were female. The mean age was 67.63±15.13 years (ranging between 23 to 89 years). The most common mechanism of fall was tipped over loose carpet, noted in 17 (42.5%) patients.  The mean intra-operative blood loss in DHS and PFNA groups were 73.75±20.06 ml, and 72.75±23.14 ml, respectively (p=0.885). The mean duration of surgery were 76.6±14.7 minutes, and 115.1±18.3 minutes in DHS and PFNA groups, respectively (p<0.001). Excellent, good, fair, poor, and failed outcomes were reported in 3 (7.5%), 17 (42.5%), 6 (15.0%), 10 (25.0%), and 4 (10.0%) patients respectively. When both groups were compared for outcomes, no statistically significant differences were observed (p=0.339). The mean HHS in DHS, and PFNA groups were 75.26±11.41, and 73.46±14.57, respectively (p=0.666). Conclusion: Functional outcomes as per HHS were relatively similar with DHS and PFNA approaches in patients with pertrochanteric fractures.

Author Biographies

Pervaiz Hashmi, Agha Khan University Hospital, Karachi, Pakistan.

MBBS, FCPS, Professor Orthopedic Surgery, 

Wajahat Alam, Agha Khan University Hospital, Karachi, Pakistan.

MBBS, Resident Orthopedic Surgery,