DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20164179

Management of stable intertrochanteric fractures with minimally invasive dynamic hip screw

Kosalaraman Padmanaban, Vivekanandhan Ramasamy, Vijay Krishnan Arcot Subramaniyan

Abstract


Background: Trochanteric fracture is the commonest fracture which accounts to 90 % of the fractures in patients over 50 years. The aim of the treatment is to prevent malunion and early mobilization with ambulation which is accomplished by dynamic hip screw and sliding plate. Minimal invasive technique has advantages of less blood loss, minimal soft tissue dissection, early mobilization and shorter hospital stay.The study was done to evaluate the amount of intraoperative blood loss, reduction of postoperative haemoglobin, requirement of postoperative analgesics and duration of postoperative hospital stay in the patients with stable intertrochanteric fracture treated with minimal invasive dynamic hip screw (MIDHS).

Methods: Twenty five patients with stable intertrochanteric fractures were treated with minimal invasive Dynamic hip screw fixation. Average intra operative blood loss, reduction of postoperative haemoglobin, requirement of post-operative analgesics and total duration of postoperative hospital stay were evaluated. All the patients were followed up periodically at 6 weeks, 3 months, 6 months, 1 year.  All the patients were evaluated radiologically in the follow up period. The functional assessment was done with Harris hip score.

Results: Mean intraoperative blood loss was found to be 75 ml. The mean duration of surgery was found to be 44.3 minutes. All the patients were mobilized 24 hours of surgery with non-weight bearing walking with walker support. The average time for union was found to be 4 months. No complications like postoperative infection, malunion, coxa vara, limb length discrepancy were seen. The final functional Harris hip score was found to be excellent in 14, good in 4, fair in 2.

Conclusions: MIDHS is a safe technique having advantages of less blood loss, minimal soft tissue dissection and shorter hospital stay, early rehabilitation in treating stable intertrochanteric fractures compared to conventional DHS.


Keywords


MIDHS, Percutaneous, Conventional DHS

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References


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