A comprehensive study of complications and management of dynamic hip screw surgery

Abstract

Background: Trochanteric fracture is one of the leading causes of hospital admissions in elderly people. The number of such admission is on the rise because of increasing life span and activity. Generalized osteoporosis, the loss of reflexes, failing eyesight and anemia are also the predisposing factor to cause trochanteric fractures.Conservative methods of treatment result in malunion with gross shortening and limitation of hip movements as well as complications of prolonged immobilization like bed sore, deep vein thrombosis and respiratory infections.Aim & Objective: Mortality & morbidity can be reduced by doing early surgery in the elderly people in case of trochanteric fractures. This study is done to analyze the complications of dynamic hip screw surgery for intertrochanteric fractures.Materials and methods:It is a prospective study which was carried out;110 cases of intertrochanteric fracture are studied with surgical intervention by dynamic hip screw. Results:In our series, majority of the patients were females in the 7th decade with self fall being the commonest mode of injury. Most of the cases were Type II according to Boyd & Griffin classification. All patients were surgically treated by dynamic hip screw after thorough evaluation. Union was noted clinically and radiologically and functional evaluation was done by Harris Hip Score. Excellent results were noted in 52(51%) of the patients, good results in 27(26%), fair in 14(13%) and poor results in 9(8%) of patients. Union was achieved in 98(96%) of the cases. The complications noted were screw cut out in 6 patients, varus collapse with shortening in 14, infection in 1, implant failure in 4 and nonunion in 4 patients in a total of 21 patients.Conclusion: From the present study, it is concluded that dynamic hip screw surgery for intertrochanteric fractures of femur is safe, reliable, achieves good union and gives excellent functional outcomes for the patient. Some complications like screw cut out can be avoided by meticulous placement of the lag screw. On the whole, this is a cost effective and excellent surgical procedure.