INTERTROCHANTERIC FRACTURE OF FEMUR

OUTCOME OF DYNAMIC HIP SCREW IN ELDERLY PATIENTS

Abstract

Background: Intertrochanteric (IT) fracture is common in elderly population. The dynamic hip screw is widely accepted in the treatment of IT fractures of the proximal femur. Objectives: To determine the outcome of dynamic hip screw in intertrochanteric fracture of femur in elderly patients. Design: A descriptive observational study Setting: Department of Orthopaedic Khyber Teaching Hospital, Peshawar.
Period: From 7th Jan 2008 to 7th Jan 2009. Material and Methods: 113 consecutive patients with intertrochanteric fracture of the femur treated with dynamic hip screw. All patients were investigated and optimized for surgery. An accurate close reduction was done under fluoroscopic control. A dynamic hip screw (DHS) was inserted by a standard technique. Patients were reviewed clinically and radiographically on 2nd, 6th, 12th and 24th weeks. Results: We studied 113 Patients of intertrochanteric (IT) fracture, 13 patients were lost to follow up and the study was completed on 100 patients. Forty seven (47.0%) patients were male and 53 (53.0%) were female. Postoperatively seven patients (7%) suffered from infections, 3 (3.0 %) patients suffered from restricted hip joint movements. There was shortening of lower limb in 3 (3.0%) patients, 2 (2.0%) patients developed non union of the fracture site, 1 (1.0%) patient develop varus deformity. Seven (7.0%) patients had implant failure, 3 of which have lag screw cut-out through superior cortex, 3 patients have broken leg screw at barrel shaft junction and 1 patient has broken leg screw at 3 sites. 77 (77.0%) healed without complications. Conclusion It is concluded that the Dynamic Hip Screw is safe, suitable and reliable method of fixation for Boyd and Griffin type I and type II intertrochanteric fracture of femur.