386 Proximal Femoral Nail (PFN) Versus Dynamic Hip Screw (DHS) In Unstable Intertrochanteric Fractures of Femur -A Comparative Clinical Study

Introduction

The goal of treatment of an intertrochanteric femoral fracture is restoration of patient's mobility as early as possible. The dynamic hip screw (DHS) has been used for several decades to treat these fractures. Proximal femoral nails (PFN) are reported to have an advantage in such fractures. This study aims at comparing the results of unstable intertrochanteric fractures femur treated with PFN and DHS.

Method

This was a prospective, randomized study which includes sixty patients. All patients were available for follow up with 30 patients in each group. The data about intraoperative blood loss, time to union, leg length shortening was collected. The functional outcome at the end of one year was evaluated using Harris Hip Score.

Results

Blood loss, duration of surgery, time to union and leg length shortening was significantly less in the patients treated with PFN (p < 0.05). The mean harris hip score for patients managed with PFN was significantly more than in DHS group, 12 months after surgery (p = 0.05).

Conclusions

PFN requires a smaller incision, lesser operative time, less blood loss and has improved functional results. In our opinion PFN may be a better fixation device for most of the unstable intertrochanteric femur fractures.

Shelf life and colonization of soil by clay based cyanobacterial inocula

Four heterocystous cyanobacteria, isolated from grasslands of Ujjain were selected to prepare the clay based inoculants. Inoculants were evaluated for shelf life in terms of the titer value at 6 month intervals for 24 months. For colonization by inoculants in natural grasslands, the clay based inocula were applied to the field at: 40, 80 and 120 kg/ha and their survival was estimated at different time interval. Fuller's earth based inoculants had showed 50-65% survival after two year storage. After showing an initial decline, the population of the inoculated cyanobacteria became stable after 3 months. The inoculated strains persisted in the soil for longer duration, even after four months, their population was about 10-70 times higher than that of the uninoculated plots.