Dynamic Hip screw is the implant of choice for most inter-trochanteric fractures of the femur. But, its most common mode of failure is for the lag screw to cut out of the femoral head, the second is for the plate to be forced off the femur with the screws being pulled out of the osteoporotic bone. With the introduction of Locking plate osteosynthesis, in which fixed angle devices are used, which are not dependent on the holding power of screws alone, the bone-implant construct so formed is mechanically stable and fixation failure due to screw loosening in osteoporotic bone can be reduced. This study aims to evaluate DHS with a locking side-plate for fixation of inter-trochanteric fractures in elderly.
Methods: Aim was to study the outcome of Locking Dynamic Hip Screw fixation in 25 patients admitted in GNDH with inter-trochanteric femur fractures in elderly age group. The clinical and radiological outcomes were evaluated with regular follow-up and the functional grading was done according to Harris Hip Score.
Results: In our study, the mean time to radiological union was 13.96 weeks. There was one patient with deep infection, but no other significant complication in our study. None of the patients in our study had lag screw cut-out, varus collapse or side plate pull out or any other implant specific complications. The average modified harris hip score was calculated to be 82.12 %. Functionally, 16 % had excellent, 48% as good, 32% as fair and 4% had poor results.
Discussion: The present study indicates that DHS with a locking side plate is a terrific treatment option for inter-trochanteric fractures in elderly, with no major complications for fracture union. To accomplish the goal of early mobilisation and reduced failures we need an implant which has an inherently stable construct independent of the bone quality and does minimal damage to the vascular supply of the bone and has a low complication rate. Locking DHS helps us achieve that goal.