A study of surgical management of intertrochanteric fracture of femur with dynamic hip screw

Author(s): J Naveen Chandra, Naga Kumar JS and PV Manohar

Abstract: Background and Objectives: Intertrochanteric fracture is a leading cause of hospital admissions in elderly people. The number of such admissions is a rise because of increasing life span & sedentary habits. Conservative methods of treatment result in malunion with shortening and limitation of hip movement as well as complications of prolonged immobilization like bed sores, DVT and respiratory infections. This study is done to analyze the surgical management and traumatic fractures using Dynamic Hip screw. Materials and Methods: This is a prospective study of 30 cases of fresh intertrochanteric fractures admitted to R.L. Jalappa hospital attached to Sri Devaraj Urs Medical College, Kolar between September 2008 and September 2010. Cases were taken according to inclusion and exclusion criteria i.e., patients with intertrochanteric fracture above the age of 18yrs. Medically unsuitable and old malunited intertrochanteric fractures were excluded from the study. Operation was done keeping the Tip Apex Distance (TAD) into consideration. Results: The study shows sex ratio of 7:3 (M:F) with maximum presentation between 51 and 65yrs with an average of 54yrs. Mode of injury was more due to fall, 24(80%); followed by RTA, 6(20%). Right side was slightly more than Left side. R:L = 19 (63.3%):11 (36.6%). 13.3% of patients had associated injury. Type II fractures were maximum with 19 cases followed by Type III&I 5& 4 cases each. Post operative results were found to be excellent in 6(20%), Good in 13(43.3%), Fair in 10(33.3%) and poor in 1(3.3%). Conclusion: This study shows that intertrochanteric fracture is common in elderly population with male preponderance mainly occurring between 51-65 years. Common mode of injury being trivial fall, right side being slightly more involved in injury. Early operative intervention with Dynamic hip screw with 135⁰ side plate with barrel gives good results, helps early mobilization of elderly patients decreasing morbidity & mortality and achieves rigid fixation even in osteoporotic bone.

DOI: https://doi.org/10.22271/ortho.2017.v3.i3k.119