Intertrochanteric fracture neck treatment with percutaneous dynamic hip screw fixation technique: understanding outcomes in elderly patients

Comparison of percutaneous dynamic hip screw fixation and conventional dynamic hip screw outcomes

  • Muhammad Ikram Assistant Professor, Department of Orthopedics, POF Hospital, Wah Medical College,WahCantt.
  • Nadia Gul Associate Professor, Department of Radiology, POF Hospital, Wah Medical College, WahCantt.
  • Sajid Ejaz Rao Professor, Department of Orthopaedics, POF Hospital, Wah Medical College, WahCantt.
  • Sadia Ijaz Senior registrar,Department of Gynaecology and Obstetrics, Izzat Ali Shah Hospital Wah Cantt
  • Munawer Latif Memon Assistant Professor, Department of Surgery, Wah Medical College, WahCantt.
  • Sohail Muzammil Consultant, Department of Orthopedics, Doctors Hospital Lahore.
Keywords: Dynamic hip screw, External fixator,, Harris Hip Score,, Hip fractures,, Intertrochanteric fracture.

Abstract

Background and Objective:

Femur fractures result in a high rate of mortality and morbidity. Objective was to compare effectiveness of percutaneous dynamic hip screw fixation technique (PC-DHS) and conventional open dynamic hip screw (DHS) in terms of mean operative time, wound size, pain scores, intraoperative blood loss, screening time, hospital stay at 2 weeks, mean full weight bearing mobilization at 6 weeks, mean hip Harris scores at 6 weeks and 3 months and mean radiological healing at 3 months in older patients having an intertrochanteric fracture of femur neck at tertiary care hospital.

Methodology:

The study design was a prospective observation study at the Department of Orthopedics, POF hospital. The study duration was 2 years (2018-2020). The sample size was 130 with 1:1 randomization in each group. Patients were selected through nonprobability sampling (lottery method) and divided into two groups; Group A underwent PC-DHS and Group B underwent conventional DHS procedure. Data was analyzed using SPSS version 24.

Results:

A total of 130 patients were studied. Patients who underwent PC-DHS showed significantly low operative time (p<0.00), wound size (p<0.00), intraoperative blood loss (p<0.00), pain scores (p<0.00), hospital stay length (p<0.00) at 2 weeks as compared to conventional DHS. PC-DHS patients showed high Hip scores (p<0.00) at 3 months and at 6 months (p<0.00). The frequency of chronic hip pain, non-union, implant failure, avascular necrosis, chronic osteomyelitis, and deep venous thrombosis was high in conventional open DHS.

Conclusion:

We found PC-DHS as a more effective and safe technique for intertrochanteric fracture fixation resulting in significant improvement in surgical outcomes at 2 weeks, 6 weeks, 3 months, and 6 months.

Published
2024-05-31
How to Cite
Muhammad Ikram, Nadia Gul, Sajid Ejaz Rao, Sadia Ijaz, Munawer Latif Memon, & Sohail Muzammil. (2024). Intertrochanteric fracture neck treatment with percutaneous dynamic hip screw fixation technique: understanding outcomes in elderly patients. Journal of University Medical & Dental College, 15(2), 803-808. https://doi.org/10.37723/jumdc.v15i2.821
Section
Original Article