Despite reliable results of the dynamic hip screw(DHS) for stable fracture patterns, complications of inadequate bone anchorage occur frequently in elderly osteoporotic patients with comminuted intertrochanteric fractures. In spite of reports in literature about use of polymethylmethacrylate (PAMMA) bone cement to prevent these complications, concerns about risk of thermal necrosis and joint penetration of cement remain. The newer techniques reported in literature are expensive and have limitations. The author presents a self designed simple, economical and effective technique of cement augmentation in DHS stabilisation of comminuted intertrochanteric fractures in elderly osteoporotic individuals. A prospective study was conducted in 80 osteoporotic patients with intertrochanteric fractures (AO type 31-A2 and 31-A3) with an average age of 71 years (range 60–94 years) and a T score of −2.5 or less on Dexa scan. Fractures were stabilised usind a DHS which was augmented with a small amount (3–5 ml) of conventional bone cement, using a specialy designed cement gun. All the pateints were permitted weight bearing from early post operative period as per their pain threshold. All the patients had a sound bony union with most of the patients regaining their pre fracture functional status. There was was no incidence of varus collapse, superior screw cut out, loss of fixation or joint penetration of bone cement. Further no evidence of any thermal necrosis was observed radiologically. The tecnique is simple, effective and economical method of cement augmented DHS stabilisation of intertrochanteric fractures in osteoporotic individuals by preventing osteoporosis related local complications without any limitations or side effects
R. Gupta (Wed,) studied this question.