THE RESULT OF INTERTROCHANTERIC FRACTURE FIXED BY DYNAMIC HIP SCREW DEPENDS ON FRACTURE PATTERN AND BONE QUALITY

摘要

Purpose: Femoral intertrochanteric fractures are usually treated by dynamic hip screw (DHS) fixation. However, this technique often causes severe sequelae for patients with severe osteoporosis and unstable fracture pattern. The purpose of this study is to classify hip fracture patterns of patients and refer to the severity of osteoporosis during preoperative evaluation in order to adopt other fixation methods in the treatment of severe fracture pattern in an effort to prevent secondary surgery. Methods: From January 2002 to February 2007we analyzed 73 patients with subsequent 60-month follow up of each patient. All patients received DHS fixation . We classified the patient results at 6 months into four categories. Among these study patients, those who needed another surgery and could not walk were considered failures. The patients' preoperative x-rays were classified according to Boyd-Griffin classification. Study patients were given 1 point for Type I and Type II fractures. Two points were given for Type III, and 3 points for Type-IV and reversed oblique fracture. One to three points were assigned for the severity of osteoporosis as it related to bone quality according to principle tensile group. For patients with scores of >5 points, the failure rate of surgery is >84%. Therefore, in this group of patients, DHS is not recommended as the first choice of treatment.