Evaluation of Dynamic Hip Screw with Trochanteric Stabilization Plate in management of Unstable Inter-Trochanteric Fractures

Gaber Kamel El Banna, Emad; Said Abdelkhalik, Waleed; Saad Mohamed Mahfouz, Mohamed

doi:10.21608/ejmr.2021.146055

Evaluation of Dynamic Hip Screw with Trochanteric Stabilization Plate in management of Unstable Inter-Trochanteric Fractures

Document Type : Original Article

Authors

Orthopedic Surgery department, Faculty of Medicine, Beni-Seuf University, Egypt

10.21608/ejmr.2021.146055

Abstract

The goal of this study is to gauge the radiological results and therefore the functional outcomes consistent with Parker mobility score of the patients after using of Dynamic hip screw with trochanteric stabilizing plate in fixation of unstable trochanteric fractures and assess the complication.
Twenty patients (ages ranged from 51 to 70 with an average age of 64.20 ± 6.338 years, 12 of them (60%) were females and 8 (40%) were males) with unstable trochanteric fracture were treated with Dynamic Hip Screw with Trochanteric Stabilization Plate between first of September 2019 to end of March 2020 at Beni-Suef University Hospital. Most of the operations were done in the first week 16 (80%) and only 4 (20%) patients had intraoperative complication and the same percent had post-operative complications. Parkers score was higher in non-diabetic patients p value (p value 0.041).The ASIA score was higher in patients with good bone quality and without intraoperative complication and this difference was statistically significant significantly (p-value, 0.011). DHS with TSP fixation of unstable intertrochanteric fractures of femur is an effective technique and has excellent functional and radiological outcomes with minimal complications and early rehabilitations rates.

Keywords

References

1. Fu, Chun-Wei, et al. "Dynamic Hip Screw with Trochanter-Stabilizing Plate Compared with Proximal Femoral Nail Antirotation as a Treatment for Unstable AO/OTA 31-A2 and 31-A3 Intertrochanteric Fractures." BioMed Research International (2020).

2. Sinan Z., R. Zehir, Sultan Z., Azboy, and N. Haykir: Proximal femoral nail antirotation against dynamic hip screw for unstable trochanteric fractures; a prospective randomized comparison. Eur J Trauma Emerg Surg. (2015); 41:393–400.

3. Koun Y,Mitsuishi N, Hisashi S, Shoji F, and Hirohiko H. Comparison of morphological features in the femur between femoral neck fractures and femoral intertrochanteric fractures Surg Radiol Anat .DOI 10.1007/s00276-(2016)-1626-9.

4. Weiser, Lukas, et al. "Extra-vs. intramedullary treatment of pertrochanteric fractures: a biomechanical in vitro study comparing dynamic hip screw and intramedullary nail." Archives of orthopaedic and trauma surgery 135.8 (2015): 1101-1106.‏ ‏

5. Lakho, Muhammad T., et al. "Functional and Radiological Outcome of Unstable Intertrochanteric Fracture Post Dynamic Hip Screw Fixation." Cureus 11.4 (2019).‏

6. Parker, Martyn J., and CHRISTOPHER R. Palmer. "A new mobility score for predicting mortality after hip fracture." The Journal of bone and joint surgery. British volume 75.5 (1993): 797-798.‏

7. Baumgaertner, Michael R., and Brian D. Solberg. "Awareness of tip-apex distance reduces failure of fixation of trochanteric fractures of the hip." The Journal of bone and joint surgery. British volume 79.6 (1997): 969-971.‏

8. Gündüz, Berrin. "ASIA Update-ASIA Impairment Scale: level determination, classification, and case examples." Turk J Phys Med Rehab 61.suppl 1 (2015): 525-531.‏

9. Griffin JB: The calcar femorale redefined. Clin Orthop (1982); 164:211–214.

10. Singh M, Nagrath AR, Maini PS: Changes in trabecular pattern of the upper end of the femur as an index of osteoporosis. Quoted from Rockwood and Green's Fractures in Adults, 10th ed. Philadelphia, J.B. Lippincott, 2014.

11. Stephen K, Thomas RG: Manual of Human anatomy, 2010; emedicine.medscape.com/article/1898964-overview

12. Dieter M Lindskog, Michael R. Baumgaertner: Unstable Intertrochanteric Hip Fractures in the Elderly. J Am Acad Orthop Surg (2004); 12:179-190

13. Coleman AL, Stone K, Ewing SK, Nevitt M, Cummings S, Cauley JA, Ensrud KE, Harris EL, Hochberg MC, Mangione CM. Higher risk of multiple falls among elderly women who lose visual acuity. Ophthalmology(2004);111:857–862.

14. Kannus P, Parkkari J, Niemi S: Prevention of hip fracture in elderly people with use of a hip protector. N Eng l J Med (2000); 343:1506-1513

15. Holick M. Resurrection of vitamin D deficiency and rickets. J Clin Invest (2006); 116(8): 2062-2072.

16. Capt Wendy L.Aronson, Ken Muller, Maura S.McAliffe. Variability in the ASA, PS classification scale. ANNA Journal. August (2003), vol. 71, no.4: 265-74.

17. Partanen: Etiopathology and treatment-related aspects of hip fracture. Acta Univ Oul D 742. 2003.

18. Kubiak EN, Bong M, Park SS: Intramedullary fixation of unstable intertrochanteric hip fractures: one or two lag screws. J Orthop Trauma 6th ed. (2006); 1793-825

19. Dell R, Greene D, Schelkun SR, Williams K: Osteoporosis disease management: the role of the orthopaedic surgeon. J Bone Joint Surg Am (2008); 90 (Suppl 4):188-194.