comparison of dynamic hip screw and proximal femoral nail anti-rotation in the treatment of a2-type intertrochanteric fractures: a randomized clinical trials

Background: dynamic hip screw (dhs) and proximal femoral nail anti-rotation (pfna) are two commonly used surgical interventions for a2-type fractures. however, a thorough comparative analysis of their efficacy and complications is essential for making informed decisions in clinical practice. objectives: this randomized clinical trial aims to compare the efficacy and adverse outcomes of dhs and pfna in treating type a2 intertrochanteric fractures. clinical and radiographic outcomes and treatment results were evaluated in both groups during the 6-month follow-up period.methods: a total of 112 eligible patients were randomly assigned to either the dhs or pfna group in a 1:1 ratio. surgical interventions were performed accordingly, and the patients were followed-up for six months. demographic factors, clinical and radiographic outcomes, bleeding during surgery, duration of surgery, duration of hospitalization, and rates of nonunion and thromboembolic events were compared between the pfna and dhs groups.results: the pfna group exhibited significantly lower bleeding volume during operation (234.21 vs 305.38 deciliter, p<0.001) and a shorter operative duration (129 minutes vs 177 minutes, p<0.001) compared to the dhs group. no significant differences between the two groups were observed in hospitalization duration, nonunion rates, or postsurgical thromboembolic events. conclusion: the pfna approach demonstrated superiority in operative duration and intraoperative bleeding volume. therefore, pfna may be preferred, especially for older patients with comorbidities.