scholarly journals Management of unstable inter-trochanteric fractures by Dynamic Hip screw versus Proximal Femur Nailing- A Comparative Analysis

Author(s):  
Dr Surendar Singh Bava ◽  
Author(s):  
Rajeev Anand ◽  
Amit Dwivedi ◽  
Anupinder Sharma

<p class="abstract"><strong>Background:</strong> Intertrochanteric fractures of the femur are difficult to manage because of the complex patterns they present with. A dynamic hip screw (DHS) and a DHS supplemented with a trochanteric stabilisation plate (TSP) are among a variety of fixation methods used in the management of such injuries. We compared the efficacy of DHS with TSP to DHS alone in the treatment of unstable intertrochanteric femur fractures.</p><p class="abstract"><strong>Methods:</strong> 30 patients of intertrochanteric femur fractures (mean age 72 years) were included in the study, 14 were treated using DHS with TSP while 16 were treated using DHS alone, they were followed up till 16 weeks and the progress was recorded according to the parameters in the Salvati and Wilson score.<strong></strong></p><p class="abstract"><strong>Results:</strong> 14 patients were treated using DHS with TSP, 11 of them had excellent Salvati and Wilson scores, 3 patients recorded good scores, 11 patients were able to walk with no pain while 3 needed aids for walking due to pain, normal function was restored in 12 patients while very little restriction was seen in 2 patients</p><p class="abstract">Of the16 patients treated using DHS alone, 10 had excellent scores, 6 recorded a good score, 10 patients walked with no pain while 6 needed aids for walking due to pain, normal function was re-stored in 11 patients, very little restriction was seen in 4 patients while 1 patient had restricted nor-mal activity.</p><p class="abstract"><strong>Conclusions:</strong> DHS with TSP appears to provide better fixation and functional outcome in unstable inter trochanteric fractures over DHS alone.</p>


2007 ◽  
Vol 40 ◽  
pp. S572-S573
Author(s):  
Shih Liang Shih ◽  
Jui-Sheng Sun ◽  
Yang-Hwei Tsuang ◽  
Chen-Sheng Chen ◽  
Cheng-Kung Cheng

1992 ◽  
Vol 41 (1) ◽  
pp. 228-232
Author(s):  
Takeshi Saito ◽  
Masashi Sagara ◽  
Hiroshi Inoue ◽  
Jyouji Noguchi ◽  
Iwao Yanagida ◽  
...  

2018 ◽  
Vol 35 (3) ◽  
pp. 413
Author(s):  
MohamedA Mostafa ◽  
HassanH Ahmed ◽  
HaniA.M Bassiooni ◽  
ElsayedM Mohamady

Injury ◽  
2017 ◽  
Vol 48 ◽  
pp. S44-S47 ◽  
Author(s):  
Mario Ronga ◽  
Daniele Bonzini ◽  
Marco Valoroso ◽  
Giuseppe La Barbera ◽  
Jacopo Tamini ◽  
...  

Author(s):  
Mithlesh Kumar Meena ◽  
Vinay Joshi

<p class="abstract"><strong>Background:</strong> Proximal femur fractures are one of the commonest fracture encountered in orthopaedic trauma practice. Dynamic hip screw (DHS) is the gold standard procedure for treatment for stable intertrochanteric  fractures, however problem arises with unstable fractures in maintenance of neck shaft angle and proper reduction. Here we are giving results of trochanteric fractures treated with proximal femoral locking compression plate (PFLCP) as compared with dynamic hip screw (DHS).</p><p class="abstract"><strong>Methods:</strong> This study was a prospective study. Two groups of trochanteric fractures of 25 patients operated with DHS and LCP were taken. Each patient was followed-up from July 2011 to October 2012 for minimum of 12 month or till the bony union.<strong> </strong>Every fracture was classified according to AO classification. Functional results will be assessed as per modified Harris hip evaluation score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 25 patient treated with PFLCP, length discrepancy was .857 cm while that for DHS was 1.2 cm. The mean time of unaided walking with LCP Was 14.20 weeks while for DHS it was 16.20 weeks. The mean varus angulation for LCP 8 degree while for DHS 10.2 degree. In LCP in 1 case screw cut out from head and neck of femur while in DHS, same is seen in 2 cases and in addition loss of position of lag screw seen in 5 cases.one case was found with superficial infection in LCP while in case of DHS 3 cases with deep infection for that implant was removed and 6 cases were found with superficial infection.</p><p><strong>Conclusions:</strong> Proximal femoral locking plate (PFLCP) is simple, stable for fixation with fewer complications, and is an effective method for unstable intertrochanteric fractures.  Comparing with DHS group, the locking plate has shorter operative time, fewer blood loss and drainage.</p>


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