Volume 24, Issue 102, March - April, 2020

Treatment of intertrochanteric fractures in elderly patients using dynamic hip screw

Quang-Tri Lê^1♦, Minh-Hoang Nguyen²

¹Department of Orthopedics, 7A Military Hospital, 466 Nguyen Trai Street, Ward 8, District 5, Ho Chi Minh City, 72706, Viet Nam; Email: lqtri@ntt.edu.vn;tsbstri@yahoo.com
²Department of Orthopedics, 7A Military Hospital, 466 Nguyen Trai Street, Ward 8, District 5, Ho Chi Minh City, 72706, Viet Nam; Email: nthoang@ntt.edu.vn; hoangbss@gmail.com

^♦Corresponding author
Department of Orthopedics, 7A Military Hospital, 466 Nguyen Trai Street, Ward 8, District 5, Ho Chi Minh City, 72706, Viet Nam. Email: lqtri@ntt.edu.vn; tsbstri@yahoo.com

ABSTRACT

Introduction: Intertrochanteric fractures are common in aged people with osteoporosis, and dynamic hip screw fixation is a promising treatment with many advantages over traditional approaches. Detailed research on fractured cases using this technique to assess its effectiveness and optimization of treatment procedures, therefore, is necessary. Objective: This study evaluated the clinical traits and radiographic data of intertrochanteric fractures in geriatric patients, treatment outcome of this injury using DHS (Dynamic Hip Screw) fixation, and drew the conclusions on surgical indications and techniques. Material and Methods: The study used a prospective approach with clinical description, radiographs, and results in the assessment. Experimental participants included 108 intertrochanteric fracture patients aged over 60, type A1 (A/O classification), treated by bone fusion using a compressive locking plate with dynamic hip screws at the 7A Hospital, Ho Chi Minh City, Viet Nam, from June 2015 to June 2019. Results: Most cases were unstable fractures, and the most common cause was falling (78.7%) in old patients with osteoporosis, occurred in females more than males, and was accompanied with various lung diseases, which posed a postoperative risk. “Good” and “acceptable” bone fusion outcomes were achieved in 96.9% cases. After more than 12 months of monitoring, “good” and “fair” functional rehabilitation was achieved in 84.6% of patients with no false joint; poor and deviated union took place in 3.1% of patients, superior cutout due to osteoporosis occurred in 7.7% of patients. Conclusions: This study showed that dynamic hip screw fixation is still a suitable treatment for A1 intertrochanteric fractures in elderly patients with osteoporosis, and it enables quick rehabilitation; however, timely surgery and good resuscitation are required to prevent complications and postoperative chronic diseases resurface.

Keywords: Intertrochanteric fractures, dynamic hip screw, geriatric fractures, elderly

Medical Science, 2020, 24(102), 912-921

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