Proximal Femoral Nail vs. Dynamic Condylar Screw in Unstable Intertrochanteric Fractures: A Randomized Comparative Study

Background: Unstable intertrochanteric femoral fractures are common in the elderly and associated with significant morbidity. This study compares the clinical, radiological, and functional outcomes of Proximal Femoral Nail (PFN) and Dynamic Condylar Screw (DCS) fixation in managing these fractures. Methods: A prospective, randomized, controlled study was conducted in the Department of Orthopaedics, S.M.S. Medical College, Jaipur, from January to December 2024. Sixty adult patients (>18 years) with unstable intertrochanteric fractures were equally divided into two groups: Group A (DCS, n=30) and Group B (PFN, n=30). Both groups underwent standardized surgical and rehabilitation protocols. Functional outcomes were assessed using the Harris Hip Score (HHS) and radiological union by the Radiographic Union Score for Hip (RUSH) at 2 weeks, 6 weeks, 3 months, and 6 months. Operative parameters, complications, and union rates were statistically analyzed. Results: The mean age was 72.3 years, with comparable demographics between groups. PFN demonstrated significantly shorter operative time (64.8 ± 7.9 vs. 112.7 ± 11.1 min; p