Key result
Dynamic hip screw fixation for unstable intertrochanteric fractures resulted in an overall acceptable functional and radiological outcome in 81.1% of patients at three months.
Why the study?
Does dynamic hip screw (DHS) fixation improve functional and radiological outcomes in patients with unstable intertrochanteric fracture?
Observational (n=106)
No
Does dynamic hip screw (DHS) fixation improve functional and radiological outcomes in patients with unstable intertrochanteric fracture?
Dynamic hip screw fixation for unstable intertrochanteric fractures yields acceptable functional and radiological outcomes in the vast majority of patients at 3 months.
DHS fixation may yield acceptable short-term results in unstable fractures; leaves open need for RCTs versus PFN before changing practice.
Introduction Intertrochanteric fractures are the most frequently operated fracture type and have the highest postoperative fatality rate. The most commonly used devices are the dynamic hip screw (DHS) with side plate assemblies and proximal femoral nail (PFN). The aim of this study was to determine the functional and radiological outcome of unstable intertrochanteric fracture post DHS fixation at a tertiary care hospital in Karachi, Pakistan. Methods A study was carried out in the department of orthopedics at the Jinnah Postgraduate Medical Center (JPMC), from 12th June 2016 to 8th September 2017. A total of 106 patients between 18 and 75 years of age with unstable intertrochanteric fracture were included. Those patients who had multiple injuries and open fractures, subtrochanteric fractures, intracapsular fractures neck of femur, pathological fractures and patients who were non-ambulatory prior to their injury were excluded. Functional outcomes were measured both during pain using the visual analog scale and range of motion on goniometer between 80 and 100 degrees. Satisfactory outcomes were measured after three months. Results A total of 106 patients with the radiological diagnosis of the unstable intertrochanteric fracture having post DHS fixation were included in this study. Out of which, 69.8% (74) were males and the mean age was 66.61 ± 7.79 years over the range of 50 to 80 years. Patients with type II diabetes were 22.6% (24) with a mean duration of 4.3 ± 8.37 years. At the end of three months, no pain was reported in 82.1% (87) patients and 85.8% (91) patients had normal function. The satisfactory radiological outcome was observed in 86.8% (92) patients. Overall, acceptable outcomes were observed in 81.1% (86) patients at the end of three months. Conclusion The treatment of unstable intertrochanteric fracture with dynamic hip screw (DHS) fixation results in better outcomes. In our study, we observed acceptable outcomes in a vast majority, 81.1%, of patients after three months of DHS fixation of the unstable intertrochanteric fracture.
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Lakho et al. (2019) conducted an observational in Unstable intertrochanteric fracture (n=106). Dynamic hip screw (DHS) fixation was evaluated on Overall acceptable outcome (satisfactory functional and radiological outcomes). Dynamic hip screw fixation for unstable intertrochanteric fractures resulted in an overall acceptable functional and radiological outcome in 81.1% of patients at three months.