Role of locking dynamic hip screw fixation in the treatment of osteoporotic intertrochanteric fractures

Abstract

Pertrochanteric femoral fractures are of intense interest globally. They are the most frequently operated fracture type, have the highest postoperative fatality rate of surgically treated fractures, and have become a serious health resource issue because of the high cost of care required after injury. Interestingly there has been no significant improvement in mortality or functional recovery over the past 50 years of surgical treatment. The treatment goal in pertrochanteric fractures is a stable and strong fixation of the fracture fragments. The failure of fixation using a dynamic hip screw (DHS) will lead to reduced mobility and the associated ill healths. Using a fixed angle locking plate in a dynamic hip screw would reduce the risk of DHS failure. This study was intended to assess the failure rate and functional outcome of intertrochanteric fractures that were treated using locking DHS. A prospective case series study was done of 30 patients who underwent dynamic hip screw fixation with locking side plate, after following them for 12 months, to find out the advantages and disadvantages occurring with the locking DHS and to look for the major postoperative complications associated with the treatment. The functional outcome was measured using Salvati –Wilson scoring system. It was found to be excellent in 39.28% and good in 42.85% of the patients after one year of follow up. In 66.67% of patients, fracture was found to be radiologically united at the 3rd month of follow up. 38.46 % of patients had complications due to technical failures. Locking DHS can be considered effective to treat trochanteric fractures in terms of functional outcome.