Intertrochanteric fractures commonly result in malunion and coxa vara if untreated. Primary nonunion of intertrochanteric fractures is a rare occurrence in young individuals. Treatment methods preserving the femoral head has better longevity than hip arthroplasty Literature regarding the outcome of dynamic hip screw fixation and bone grafting in these patients is limited.
Methods: 15 patients who underwent DHS fixation with bone grafting for primary nonunion of intertrochanteric fractures in young patients were studied retrospectively. Their epidemiological profile, neck shaft angle, limb length, visual analog scale and modified harris hip score were recorded and compared. Time to union and complications were noted. Statistical analysis was done with paired student t test.
Results: Average time to fracture union was 18 weeks. Limb length and neck shaft angle improved from 3.6cm shortening, 105 degrees to 0.5cm and 129 degrees respectively. Modified harris hip score showed statistically significant improvemet from 24.5 to 73.8.
Conclusion: DHS is a good surgical option in primary nonunion of intertrochanteric fractures in patients with good bone stock. Because native femoral head is being retained, activities of daily living in these patients become near normal.