Waqar Alam, Roohulla Jan, Muhammad Imran Khan, Shams-ur Rehman, Faaiz Ali Shah, Saeed Ahmad.
Our experience of dynamic hip screw fixation for intertrochanteric fracture of femur.
Pak J Surg Jan ;31(3):200-3.

Background: Hip fracture is the most serious osteoporotic fracture. Th e risk of falling increases with age and is somewhat higher in elderly women than in elderly men. Intertrochanteric fractures pose a challenge to the orthopaedic surgeon typically, an elderly patient who tolerates recumbence poorly. Intertrochanteric fractures in the elderly are associated with high rates of mortality, ranging from 15 to 20%, as they are at a high risk for deep vein thrombosis (DVT), urinary tract infections, and pulmonary embolism if they fail to mobilize or ambulate early. Stable fracture fi xation is the goal of treatment. a wide variety of implants and fi xation strategies have been utilized for the surgical stabilization of intertrochanteric hip fractures. Th e introduction of the sliding compression hip screw and side plate in the 1950s was considered a major advance over previous nail-plate devices. Th e sliding compression hip screw and side plate, which has a blunt end to decrease femoral head penetration and screw threads to increase head purchase, became the implant of choice for the fi xation of intertrochanteric fractures in the latt er half of the twentieth century. Th e purpose of this study is to evaluate the out come of dynamic hip screw fi xation for inter trochanteric fractures. Methods: Th is study was conducted at Orthopaedic and Trauma unit of District Headquarter Hospital Timergara, Dir Lower and Khalifa Gul Nawaz Teaching Hospital Bannu from May 2012 to December 2013. Total of 86 patients of both genders with closed Intertrochanteric fracture of femur with skeletal maturity were included in this study. All patients were operated under image intensifi er aft er routine investigations and fi tness for anesthesia. Patients were followed up for 6 months. Results were analyzed with Kyle’s et al criteria into excellent, good, fair and poor. Results: Out of 86 patients 47 (54.65 %) were males while 39 (45.35 %) were females. Mean age was 67.36 years, ranging from 35 to 105 years. Results were analyzed according to Kyle’s et al criteria. Out of 73 patients 18 (24.66%) had excellent results, 43 (58.91%) had good results, 9 (12.33%) had fair results while 3 (4.11%) patients had poor results. Conclusion: In conclusion intertrochanteric fractures fixation with dynamic hip screw is an effective, simple and safe method. Th e treatment of trochanteric fracture of the femur by dynamic hip screw greatly simplifies nursing care, allows early mobilization and reduces morbidity and mortality. Th e most important point of consideration is the achievement of stable fixation of the unstable fracture, so that early walking with crutch support would be possible.

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