Abstract
Introduction: Dynamic Hip Screw (DHS) fixation is one of the most common orthopaedic surgical procedures. Tip Apex Distance (TAD) is a well recognised method of evaluating the screw position of the DHS. We studied the adequacy of fixation of DHS by assessing TAD and type of reduction.
Materials and Methods: We selected a random cohort of 102 patients who had DHS fixation and had the requisite clinico-radiologic data. TAD is defined as sum of the distance, in millimeteres, from the tip of the lag screw to the apex of femoral head, as measured on AP radiograph and Lateral radiograph, after correction has been made for radiological magnification. Tip apex distance of 25 mm or less is considered as good, 26–30mm as acceptable, 31–35mm as poor and more than 35mm as unacceptable.
Quality of reduction was assessed as per Sernbo. Good, if alignment was normal on AP and maximum 20 degrees angulation on lateral radiograph and less than 4mm of displacment of any fragment. To be labelled acceptable, a reduction had to meed the criteria of a good reduction with respect to either alignement or displacement, but not both. A poor reduction met neither.
Results: Mean TAD in our series was 24mm. (9.84 – 37.6). Our of this 58.82% were 25mm or less indicating good, 25.49% of them were 26–30mm indicating acceptable, 8.82% were 30–35mm indicating poor and 6.8% were more than 35mm indicating unacceptable. 39.21% patients had good reduction. 43.13% had acceptable reduction and 17.64% had poor reduction.
Conclusion: This study shows that only 58.82% of all patients having DHS fixation had good placement of the fixation device and only 39.21% had a good reduction. We conclude that complacency must not set in on DHS fixation and that we must endeavour for good reduction and placement in as many cases as possible.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
