DYNAMIC HIP SCREW (DHS)

Objectives: To analyze the comparative results of dynamic DHS fixation in stableand the unstable intertrochanteric fractures at LUH. Study Design: Comparative study. Setting:Orthopedic unit I of LUH Jamshoro. Period: 26th May 2010 – 25th August 2011. Methodology:All 40 patients with femur intertrochanteric fracture were enlisted. All cases isolated in 2 groupsevery having 20 patients, group A stable fracture and group B unstable fractures. After completephysical examination, examinations and fracture arrangement evaluation, patients were readiedfor operation. Fracture table was used in each operation. Fracture reduction was initiallyattempted by close manipulation and was successful in 30 (75%) cases. Lateral approach forproximal femur was used in every case. All fractures, whether stable or unstable, were reducedanatomically without any type of osteotomy and then fixed with 135o dynamic hip screw.Results: Mean age was 62.8.2 years of the cases. Gender ratio was 3:1. According to modeof injury were found RTA in 21 (70%) patients. Postoperative complications were recorded as;superficial infection noted in 2 (5%) patients and there was no case of deep infection. Averagestay of hospital found 16.5 days in 17 (42.5%) patients belongs to stable group and 06 (15%)patients belong to unstable group. All (n=40) patients were pain free on their discharge fromhospital. In all (n=40) patients we achieved union and there was no case of delayed unionor non-union. We assessed functional outcome of our patients on the base of Stinchfield HipAssessment system. According to SHAS 28 (70%) patients were excellent, 05 (12.5%) patientswere good, 04 (10%) were fair and 03 (7.5) were poor. We had not found mortality in our patients.Conclusions: According to our conclusion DHS is the best implant for intertrochanteric fracturefixation. No matter; whether fracture is stable, unstable and fresh or old.