DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20195815

A study of an operative outcome of a basitrochanteric fractures of the hip treated by dynamic hip screw and enders nail with percutaneous canulated cancellous screw

Ambrish J. Vyas, Vijay J. Patel, Keval H. Patel, Ravi G. Panchal

Abstract


Background: Basicervical or cervicotrochanteric fracture of the femur is considered stable variety of fracture pattern. Most common incidence is seen in elderly patient and in young patient with probably high energy trauma. Appropriate Osteosynthesis confers excellent outcome when reduction is optimally achieved.

Methods: 86 basitrochanteric fractures had been treated with enders nail or dynamic hip screw (DHS) at our institute by a single surgeon. Implant selection was done purely based on plain radiograph, associated co-morbidities and fracture geometry. Patients had been followed up at 1 month, 3 month and 6 month.

Results: In our study there were 86 patients out of which 63 patients (73.25%) were treated with enders nail and 23 patients (26.74%) were treated with DHS. Mean age of patients was 57 years. We noted minimum follow up of 8 months while maximum follow up of 4.5 years where as mean follow up duration is 18 months. We almost noted excellent to fair results in both groups.

Conclusions: Most of the implants in basitrochanteric fractures worked on control collapse principle. Both DHS and enders nail with percutaneous cc screw follow this principle and when used with a proper technique, optimal reduction usually fetch the favourable outcomes with minimalistic approach.


Keywords


Basitrochanteric fracture, Enders nail, DHS, Harris hip score

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References


International Osteoporosis Foundation: Hip Fracture. Available at https://www.iofbonehealth.org/facts-statistics# category-16. Accessed on 16 June 2019.

Ender J, Simon-Weidner R. Die Fixierung der trochanteren Briiche mit runden elastischen Condylennageln. Acta Chir. Austriaca. 1970;1:40-2.

Socci AR, Casemyr NE, Leslie MP, Baumgaertner MR. Implant options for the treatment of intertrochanteric fractures of the hip: rationale, evidence, and recommendations. Bone Joint J. 2017;99-B:128-33.

Hsu CE, Shih CM, Wang CC, Huang KC. Lateral femoral wall thickness. A reliable predictor of postoperative lateral wall fracture in intertrochanteric fractures. Bone Joint J. 2013;95–B:1134-8.

Harris WH. Harris hip score. JBJS. 1969;51:1.

Jacobs RR, Armstrong HJ, Whitaker JH, Pazell J. Treatment of intertrochanteric hip fractures with a compression hip screw and a nail plate. J Trauma. 1976;16:599-603.

Sernbo I, Johnell O, Gentz CF, Nilsson JA. Unstable intertrochanteric fractures of the hip: Treatment with Ender pins compared with a compression hip-screw. J Bone Joint Surg Am. 1988;70:1297-303.

Baumgaertner MR, Curtin SL, Lindskog DM. Intramedullary versus extramedullary fixation for the treatment of intertrochanteric hip fractures. Clin Orthop Relat Res. 1998;348:87-94.

Zain Elabdien BS, Olerud S, Karlstrom G. Ender nailing of pertrochanteric fractures. Complications related to technical failures and bone quality. Acta Orthop Scand. 1985;56(2):138-44.