SURGICAL OUTCOME OF PATIENTS WITH TRAUMATIC STABLE AND UNSTABLE INTER-TROCHANTERIC FRACTURES TREATED WITH DYNAMIC HIP SCREW.

摘要

Introduction: Hip fractures are a leading cause of death and disability amongelderly. Approximately half of these injuries are intertrochanteric fractures and the incidence iscontinuously increasing. These fractures are the most common injuries around the hip regionand are more common in elderly people. Different types of implants were tried at differenttimes for internal fixation of these fractures, of which dynamic hip screw has remained the mostpopular one. But with the advent of some newer implants, the efficacy of dynamic hip screwis being questioned. Objectives: To determine the results of dynamic hip screw as a methodof internal fixation in closed stable as well as unstable intertrochanteric fractures of femur inadults. Design: Descriptive case series. Setting: The study was conducted in orthopedicdepartment Allied Hospital Faisalabad. Period: 11months (from 26th, march, 2015 to 25th Feb,2016). Subjects and Methods: Sixty cases of intertrochanteric fractures were included andoperated for internal fixation with dynamic hip screw under fluoroscopic guidance. Pre, per andpost-operative findings during hospital stay and follow-up period were recorded. Results: Wehad a total 60 cases, 20 patients in group A stable intertrochanteric fractures and 40 patientsin group B unstable intertrochanteric fractures. We have reported the follow up study up to 20weeks. There were 10 (50%) male and 10 (50%) female in group A. In group B 27 (67.5%) malesand 13 (32.5%) females. The youngest pt was 25 years in group A and 16 years in group B. Themean age in group A was 59.10 and st/deviation 16.942. In group B mean age was 54.85 and st/deviation 14.123. Infection rate in group A was 5%. In group B superficial infection was 5% anddeep infection was 2.5%. Nonunion in both groups was 5%. The failure rate was 5% in group Aand 20% in group B. Conclusion: The use of Dynamic hip screw with aside plate is associatedwith good results and acceptable complication rate. Dynamic hip screw is implant of choice inboth stable and unstable intertrochanteric fractures.