Dynamic hip screw technique in the management of trochanteric fracture

N. V. Narasimha Rao, C. Siva Rama Krishna, K. Aditya, T. Jaya Chandra


Background: Study was conducted to find the results of dynamic hip screw in the management of trochanteric fracture by analyzing the factors which influence post-operative mobility.

Methods: Study was conducted in the department of orthopedics, GSL Medical College. Individuals >18 years, both genders who were diagnosed having trochanteric type I and II Boyd and Griffin stable fractures were included in the study. All surgeries were performed under spinal anesthesia, internal fixation with dynamic hip screw and 135o angled blade plate. Injectable third generation cephalosporins were used 24 hours preoperatively, intra- operatively and 5 days post-operatively, and oral antibiotics till suture removal. Patients allowed to sit on bed on 2nd and 3rd day and static quadriceps exercises were started from 2nd day onwards, hip and knee flexion exercises from 6 or 7th day and weight bearing walking form 10th day.

Results: The average age was of the participants was 61.53 years, ranged between 41 to 80 years; 65% were female participants and 35% were male patients. In the study, 20 (50%) patients had right side fracture and left sided affection of trochanteric fracture to the remaining 50%. Most of the patients (67.5%) in this study were classified as type II Boyd and Griffin criteria, and 32.5% were type I. The clinical and functional outcome was calculated using the Kyle's criteria; 25% (10) showed excellent response, followed by good (50%), fair (15%) and poor (10%) results.

Conclusions: Dynamic hip screw is the operative treatment of choice for stable trochanteric fractures. However, studies on large sample for long time are recommended.


Femur, Fracture, Operative

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Falch JA, Liebekk A, Slungaard U. Epideomology of hip fractures in Norway. Acta Orthop Scand. 1986;56:12–6.

Wong PCN. Femoral neck fracture samong the major acial groups in Singapore. Incidence pattern compared with nonasian communities. Singapore Med. 1984;J5:150–7.

Boyd HB, Griffin LL. Classification and treatment of trochanteric fractures. Arch Surg. 1949;58:853.

Singh M, Nagrath AR, Maini PS. Changes in trabecular pattern of the upper end of the femur as an index of osteoporosis. J Bone Joint Surg Am. 1970;52(3):457–67.

Liu Z, Gao H, Bai X, Zhao L, Li Y, Wang B. Evaluation of Singh Index and Osteoporosis Self-Assessment Tool for Asians as risk assessment tools of hip fracture in patients with type 2 diabetes mellitus. J Orthop Surg Res. 2017;12(37):2–7.

Kyle RF, Gustilo RB, Premer RF. Analysis of six hundred and twenty two cases of intertrochanteric fractures of the femur. J Bone Joint Surg Am. 1979;61:216–21.

Endigeri P, Pattanashetty OB, Banapatti DB, Pillai A, Ullas T. Outcome of intertrochanteric fractures treated with proximal femoral nail: A prospective study. J Orthop Traumatol Rehabil. 2015;8:25–9.

Ganz R, Thomas RJ, Hammerle CP. Trochanteric fractures of the femur treatment and results. Clin Orthop. 1979;138:30–40.

Boyd HB. Anderson LD. Management of unstable trochanteric fractures. Surg Gynecol Obstet. 1961;112:633

Pathak KP. Trochanteric fractures. Ind J Othop. 1984;22:123–5.

Waddell JP, Czitrom A, Simmons EH. Enders nailing in fractures of proximal femur. J Trauma. 1987;27:911–6.

Ecker ML, Joyce JJ, Kohl EJ. The treatment of trochanteric hip fractures using compression screw. J Bone Joint Surg. 1975;57:23–7.

Parker MJ. Cutting of dynamic hip screw related to its position. J Bone Joint Surg. 1992;74:625–69.

Dolk T. Operation on hip fracture patient Analysis of the time factor. Injury. 1990;21:369–92.

Kyle RR, Gustilo RB, Fremer RR. Analyses of six hundred and twenty two inter trochanteric fractures. J Bone Joint Surg. 1979;61:216–22.

Kufer K, Matthews LS, Sonstegard D, Michigan AA. Stable fixation in inter trochanteric fractures. J Bone Joint Surg. 1974;56:889-907.

Davis RTC, Sher JL, Horsman A, Simpson M, Checketts RG. Inter trochanteric femoral fracture, mechanical failure after internal fixation. J Bone Joint Surg1990;72:26-31.

Mainds CC, Newman RJ. Implants failure in proximal fractures of femur treated with sliding screw device. Injury. 1989;20:98-100.

Parker MJ. Cutting of dynamic hip screw related to its position. J Bone Joint Surg. 1992;74:625-8.

Jensen JS, Tondvald E, Sonnee HS. Stable inter trochaneric fractures: A Comparative analysis of four methods of internal fixation. Acta Orthop Scand. 1980;51:811-6.

Dimon JH, Hughston JC. Unstable intertrochanteric fractures of the hip. J Bone Joint Surg. 1967;49:440.

Sarmiento A, Williams EM. The unstable inter troch anteric fracture of the femur. Clin Orthop. 1973;92:77.

Esser MP, Kassab JY, Jones DHA. Troch anteric fracture of the femur. J Bone Joint Surg. 1986;68:557-60.