Vol. 11, Issue 3 (2025)

Background: Intertrochanteric fractures are among the most common hip fractures in elderly populations, often resulting in significant morbidity and functional limitations. The Dynamic Hip Screw (DHS) is widely used for fixation; however, complications such as screw cut-out, delayed union, and impaired functional recovery remain concerns, particularly in unstable fractures.
Aim of the study: To evaluate complication rates, radiological healing patterns, functional outcomes, and predictors of surgical failure in patients with intertrochanteric fractures treated with DHS.
Methods: A quasi-experimental study was conducted at a tertiary care center from September 2022 to September 2024. Twenty-six patients with Kyle Type 1 (n=14) and Type 2 (n=12) intertrochanteric fractures underwent DHS fixation. Demographic, clinical, and operative data were collected, including tip-apex distance (TAD), quality of reduction, and lag screw position. Postoperative outcomes assessed were complications, radiological union, delayed union (>20 weeks), non-union (at 6 months), and functional recovery measured by Harris Hip Score (HHS). Statistical analyses included t-tests, chi-square/Fisher’s exact tests, and relative risk calculations, with p<0.05 considered significant.
Result: The mean age was 67.7±10.3 years; 61.5% were female. Superficial wound infection occurred in 7-8% of patients; screw cut-out occurred only in Type 2 fractures (16.7%). Type 1 fractures demonstrated significantly faster union (12.4±2.3 vs. 16.2±3.1 weeks; p=0.002) and higher HHS (85.6±7.2 vs. 74.8±9.5; p=0.004). TAD >25 mm, poor reduction, and non-central lag screw placement were significant predictors of complications.
Conclusion: DHS provides reliable fixation with satisfactory healing and functional outcomes in stable intertrochanteric fractures. Optimal reduction and implant positioning are essential to minimize complications, especially in unstable fractures.