Abstract
Dynamic Hip Screw fixation for intertrochanteric fracture of femur is one of the most common operations in the trauma list of any DGH. The operation is commonly performed by the registrar or senior house officer as it is considered to be a relatively simple procedure. However the reality is slightly different as we audit our results of DHS fixation over a period of 2 years from May 2002 to August 2004. Out of 184 DHS fixation done during the abovementioned period, we identified 18 (10%) failures within 2–8 weeks postoperative period. We reviewed the pre-operative and post-operative X-rays to identify the possible reasons for failure. The reasons were inappropriate indication for DHS – 3 cases, inadequate fracture reduction – 6 cases, inappropriate implant placement −12 cases. 3 cases (16%) of failure had to be treated conservatively due to poor medical condition, 7 cases (39%) had the implant removed or revised and some type of arthroplasty was done in rest 8 cases (45%). Of the 15 cases treated operatively 12 had satisfactory outcome in terms of pain relief and movement and the rest 3 had residual pain, inadequate restoration of mobility affecting the quality of life. All patients had significant morbidity (prolonged hospital stay, depression) due to the failure of fixation and further operative procedures. Therefore we think appropriate guidance by experienced personnel is necessary for correct indication and meticulous operative technique.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
