scholarly journals Analysis of the Effect of Dynamic Hip Screw and Anatomical Locking Plate

2015 ◽  
Vol 4 (4) ◽  
pp. 11
Author(s):  
Rong Ren ◽  
Ying Ren ◽  
Junhua Ji
Keyword(s):  
Locking Plate ◽  
Operation Time ◽  
The Elderly ◽  
Healing Time ◽  
Dynamic Hip Screw ◽  
Intertrochanteric Fractures ◽  
Successful Operation ◽  
Postoperative Drainage ◽  
Hip Screw ◽  
Intertrochanteric Femur Fracture

<p><strong>Objective: </strong>To analyze the effects of dynamic hip screw (DHS) and anatomical locking plate in the treatment of intertrochanteric fractures in elderly patients. <strong>Method: </strong>56 cases of intertrochanteric femur fracture from March 2009 to October 2011 were treated by surgical treatment. The cases were divided into A and B groups with A group treated with DHS and B group with anatomical locking plates. <strong>Results</strong><strong>: </strong>Treatments of the two groups were successful. Operation time, bleeding volume, postoperative drainage, hospitalization time and fracture healing time of B group were significantly less than that of A group (<em>p</em> &lt; 0.05). The incidence of postoperative complications in B group was significantly less than that in the A group (<em>p</em> &lt; 0.05). The excellent and good ratings of B group was 93.1% and 66.7% for the A group. The fine rating of B group was higher than that of A group (<em>p</em> &lt; 0.05). <strong>Conclusion: </strong>Anatomical locking plate internal fixation for the treatment of intertrochanteric fractures in the elderly has certain advantages.</p>

scholarly journals A comparative study of Dynamic Hip Screw and Proximal Femoral Nail in the management of Intertrochanteric Fractures of the Femur

2021 ◽  
Vol 24 (1) ◽  
pp. 14-18
Author(s):  
Sandeep Gurung ◽  
Gopalsagar DC
Keyword(s):  
The Elderly ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Distinct Advantage ◽  
Unstable Fracture ◽  
Intertrochanteric Fractures ◽  
Femoral Nail ◽  
Clinical And Radiological Outcome ◽  
Hip Screw ◽  
Intertrochanteric Femur Fracture

Introduction: Intertrochanteric fractures account for approximately half of the hip fractures in the elderly because of the osteoporotic nature of the bone. There are various modalities to treat these fractures. The objective of this study was to compare and evaluate the clinical and radiological outcome of intertrochanteric femur fracture treated with Dynamic hip screw (DHS) and proximal femoral nail (PFN). Methods: This study was conducted at Nepalgunj medical college, Department of orthopedics Nepalgunj over a time span of two years. A total of 52 patients were included and randomized into Dynamic hip screw (n=26) and Proximal femoral nail (n=26) group. Patient’s demographic details, perioperative findings, radiological findings and follow up findings were recorded. The results were evaluated and compared. Results: The mean age in our study was 57.63 years. Trivial fall was the most common mode of injury. There was significantly higher intraoperative blood loss in the DHS group. Radiological union and functional outcomes were similar overall, but in case of unstable fracture functional outcome was clinically better in PFN group. Conclusion: From our study we concluded that PFN has better outcome in case of unstable intertrochanteric fractures, however in stable fracture also it has distinct advantage over DHS.

scholarly journals Dynamic Hip Screw with Trochanter-Stabilizing Plate Compared with Proximal Femoral Nail Antirotation as a Treatment for Unstable AO/OTA 31-A2 and 31-A3 Intertrochanteric Fractures

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Chun-Wei Fu ◽  
Ji-Ying Chen ◽  
Yueh-Ching Liu ◽  
Kuang-Wen Liao ◽  
Yung-Chang Lu
Keyword(s):  
Intertrochanteric Fracture ◽  
Operation Time ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Intertrochanteric Fractures ◽  
Residual Pain ◽  
Unstable Intertrochanteric Fracture ◽  
Hip Screw ◽  
Proximal Femoral Nail Antirotation ◽  
Im Nailing

Background. The dynamic hip screw (DHS) with the addition of an angular stable trochanter-stabilizing plate (TSP) has been considered the ideal treatment for the unstable intertrochanteric fracture type. However, there have been few comparisons between DHS+TSP augmentation with intramedullary (IM) nailing. The aim of this retrospectively registered study was to compare the clinical outcomes of patients with the unstable type of intertrochanteric fractures treated with DHS+TSP or IM nailing (proximal femoral nail antirotation (PFNA)). Methods. From June 2013 to April 2018, 358 patients with proximal femur fracture AO/OTA type 31A2 and 31A3 treated with PFNA or DHS+TSP and followed for ≥10 months postoperatively were included. The surgical-dependent outcome evaluation included the operation time, intraoperative blood loss, postoperative decrease in hemoglobin, and blood transfusion amount. Functional status was also measured. Radiographic findings and postoperative complications were recorded and analyzed. Result. The operation time was significantly shorter in the DHS+TSP group than that in the PFNA group for both A2 and A3 fractures (A2 type: 84.0 vs.96.4 min; p<0.05; A3 type: 102.4 vs.116.1 min; p<0.05). Postoperative decrease in hemoglobin was more significant in the PFNA group than that in the DHS+TSP group for both fracture types (A2 type: −1.88 vs. −1.29 (mg/dL); p<0.05; A3 type: −1.63 vs. −1.04 (mg/dL); p<0.05). However, the patients treated with DHS+TSP had significantly more residual pain than those treated with PFNA during the final follow-up (Visual Analog Scale score, A2 type: 28.4 vs.23.2; p<0.05; A3 type: 27.5 vs.23.6; p<0.05) and complained of greater implant irritation. Conclusion. We found that DHS+TSP was associated with less operation time and less postoperative decrease in hemoglobin but more residual pain and implant irritation than those of PFNA. As a treatment for unstable intertrochanteric fracture, DHS+TSP provided ideal surgical outcomes which were not inferior to the PFNA.

scholarly journals Randomized control trial comparing the functional outcomes of dynamic hip screw and locking plate dynamic hip screw in intertrochanteric fractures of femur

2020 ◽  
Vol 6 (3) ◽  
pp. 525
Author(s):  
Kiran Ramachandran ◽  
Dileep Sasidharan ◽  
Oommen Mathew
Keyword(s):  
Functional Outcomes ◽  
Locking Plate ◽  
Dynamic Hip Screw ◽  
Research Centre ◽  
Harris Hip Score ◽  
Intertrochanteric Fractures ◽  
Neck Shaft Angle ◽  
Operative Care ◽  
Significant Difference ◽  
Hip Screw

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the functional outcomes of intertrochanteric fractures of the femur treated with dynamic hip screw (DHS) and locking plate DHS in elderly.</p><p class="abstract"><strong>Methods:</strong> 48 participants (23 in DHS and 25 in locking plate DHS) aged ≥ 50 years with intertrochanteric fracture of femur were enrolled in the present randomized open label parallel group trial conducted at Pushpagiri Institute of Medical Sciences and Research Centre during a period of 1 year. Open, pathological, other fractures in the same limb and participants with neurological involvement were excluded. Standard of care (pre and post-operative care) was given to all participants. Sociodemographic, radiological findings, fracture type and Singh’s index were recorded at baseline, 6 weeks, 3 and 6 months. Study commenced after approval from Institutional Ethics Committee and written informed consent was obtained from all study participants. Participants were randomized in 1:1 ratio using coin flip method. Quantitative variables were expressed means and medians and qualitative variables were expressed as proportions. Tests of significance were independent sample t test, Mann Whitney U test, Friedman test and Chi square test.<strong></strong></p><p class="abstract"><strong>Results:</strong> Between DHS and locking plate DHS, no significant difference in baseline parameters, neck shaft angle, tip apex distance, shortening, Harris hip score, range of motion score and length of hospital stay were observed.</p><p class="abstract"><strong>Conclusions:</strong> The functional outcomes and complications between DHS and locking plate DHS were not significantly different.</p>

scholarly journals A comparative study between proximal femur locking compression plate and dynamic hip screw fixation in management of intertrochantric femur fractures

2016 ◽  
Vol 2 (4) ◽  
pp. 327
Author(s):  
Mithlesh Kumar Meena ◽  
Vinay Joshi
Keyword(s):  
Locking Plate ◽  
Locking Compression Plate ◽  
Dynamic Hip Screw ◽  
Intertrochanteric Fractures ◽  
Trochanteric Fractures ◽  
Superficial Infection ◽  
Femur Fractures ◽  
Compression Plate ◽  
Hip Screw ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Proximal femur fractures are one of the commonest fracture encountered in orthopaedic trauma practice. Dynamic hip screw (DHS) is the gold standard procedure for treatment for stable intertrochanteric  fractures, however problem arises with unstable fractures in maintenance of neck shaft angle and proper reduction. Here we are giving results of trochanteric fractures treated with proximal femoral locking compression plate (PFLCP) as compared with dynamic hip screw (DHS).</p><p class="abstract"><strong>Methods:</strong> This study was a prospective study. Two groups of trochanteric fractures of 25 patients operated with DHS and LCP were taken. Each patient was followed-up from July 2011 to October 2012 for minimum of 12 month or till the bony union.<strong> </strong>Every fracture was classified according to AO classification. Functional results will be assessed as per modified Harris hip evaluation score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 25 patient treated with PFLCP, length discrepancy was .857 cm while that for DHS was 1.2 cm. The mean time of unaided walking with LCP Was 14.20 weeks while for DHS it was 16.20 weeks. The mean varus angulation for LCP 8 degree while for DHS 10.2 degree. In LCP in 1 case screw cut out from head and neck of femur while in DHS, same is seen in 2 cases and in addition loss of position of lag screw seen in 5 cases.one case was found with superficial infection in LCP while in case of DHS 3 cases with deep infection for that implant was removed and 6 cases were found with superficial infection.</p><p><strong>Conclusions:</strong> Proximal femoral locking plate (PFLCP) is simple, stable for fixation with fewer complications, and is an effective method for unstable intertrochanteric fractures.  Comparing with DHS group, the locking plate has shorter operative time, fewer blood loss and drainage.</p>

scholarly journals Analysis of Failure of Dynamic Hip Screw Fixation in the Management of Intertrochanteric Fractures in the Elderly

2018 ◽  
Vol 86 (9) ◽  
pp. 2149-2158
Author(s):  
ASHRAF M.M. RASHAD, M.Sc.; ALI M. EMRAN, M.D. ◽  
OSAMA A. SELEEM, M.D.; MOSTAFA H. HEGAZY, M.D.
Keyword(s):  
Screw Fixation ◽  
The Elderly ◽  
Dynamic Hip Screw ◽  
Intertrochanteric Fractures ◽  
Hip Screw

scholarly journals Percutaneous Compression Plate versus Dynamic Hip Screw for Treatment of Intertrochanteric Hip Fractures: A Meta-Analyse of Five Randomized Controlled Trials

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Lei Zhang ◽  
Jie Shen ◽  
Shengpeng Yu ◽  
Qiang Huang ◽  
Zhao Xie
Keyword(s):  
Blood Loss ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Operation Time ◽  
Dynamic Hip Screw ◽  
Plate Versus ◽  
Controlled Trials ◽  
Intertrochanteric Fractures ◽  
Randomized Controlled ◽  
Hip Screw

Background. Percutaneous compression plating (PCCP) has been advocated to reduce blood loss, relieve pain, and lead to faster rehabilitation for the treatment of intertrochanteric fractures. The purpose of this meta-analysis was to estimate the outcomes and complications of the PCCP versus dynamic hip screw (DHS) fixation for intertrochanteric fractures.Methods. All randomized controlled trials (RCT) that compared PCCP with DHS in treating adult patients with intertrochanteric fractures were included. Main outcomes were collected and analysed using the RevMan 5.1 version.Results. Five trials met the inclusion criteria. Compared with DHS, PCCP had similar operation time (95% CI: −26.01~4.05,P= 0.15), length of hospitalization (95% CI: −1.79~1.25,P= 0.73), mortality (95% CI: 0.37~1.02,P= 0.06), incidence of implant-related complications (95% CI: 0.29~1.82,P= 0.49), and reoperation rate (95% CI: 0.41~3.05,P= 0.83). But blood loss (95% CI: −173.84~−4.81,P= 0.04) and transfusion need (95% CI: −0.53~−0.07,P= 0.01) significantly favored the PCCP.Conclusions. The PCCP was associated with reduced blood loss and less transfusion need, but similar to DHS in other respects. Owing to the limitations of this systematic review, more high-quality RCTs are still needed to assess the clinical efficiency of PCCP.

scholarly journals Dynamic Hip Screw (DHS) versus Proximal Femoral Nail Anti-rotation (PFNA) Fixation for Unstable (Evans-Jensen II and III) Inter-trochanteric Fractures of Femur in Elderly

2019 ◽  
Vol 15 (3) ◽  
pp. 222-225
Author(s):  
Manoj Kandel ◽  
Robin Shrestha ◽  
Krishna Prasad Poudel ◽  
Shrawan Thapa ◽  
Sushil Thapa ◽  
...  
Keyword(s):  
Average Length ◽  
Trochanteric Fracture ◽  
Operation Time ◽  
Healing Time ◽  
Dynamic Hip Screw ◽  
Proximal Femoral Nail ◽  
Trochanteric Fractures ◽  
Femoral Nail ◽  
Fixation Group ◽  
Hip Screw

Background: Dynamic hip screw (DHS) and proximal femoral nail anti-rotation (PFNA) are the two most commonly used fixation devices for inter-trochanteric fracture of femur. However, many clinical studies have shown lack of differences in the  clinical outcome consistently with between these two fixation techniques. The main objective of this study is to compare the results of dynamic hip screw (DHS) and proximal femoral nail anti-rotation (PFNA) fixation in elderly patients with unstable inter-trochanteric fractures of femur. Methods: We retrospectively reviewed patients who underwent operative management for inter- trochanteric fractures of femur in our hospital between February 2013 and September 2017. Elderly   patients (Age >60yrs) with unstable inter-trochanteric fracture of femur treated either with DHS fixation or with PFNA fixation were included and divided into two groups: DHS fixation group and PFNA fixation group. The comparative statistical analysis was done between two group using following   parameters: average length of the incision, operation time, blood loss, fracture healing time, and degree of postoperative functional recovery. Results: The mean follow-up period, in DHS fixation group was 16 month (range 12 to 24 months) and in PFNA fixation group was 14 months (range 12 to 18 months). The differences between two groups regarding average length of the incision, operation time, and blood loss were statistically significant (p<0.05) and better in PFNA group whereas the differences between two groups regarding fracture healing time and the degree of postoperative functional recovery were not statistically significant (p >0.05). Conclusions: PFNA fixation may be  better than DHS fixation for the treatment of unstable inter-trochanteric fractures of the femur in the elderly. However, the application and usage of DHS fixation could not be neglected and the choice of treatment depends upon the systemic condition and socioeconomic status of the patient, patient’s preferences, surgeon’s experience and availability of treatment facility.

Cement-augmented dynamic hip screw (DHS) to manage intertrochanteric fractures (ITFs) in the elderly

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Alaa M. El-Senbsy ◽  
Ahmed A. Khalifa ◽  
Hamdy Tammam ◽  
El Sayed Said ◽  
Hesham Refae
Keyword(s):  
The Elderly ◽  
Dynamic Hip Screw ◽  
Intertrochanteric Fractures ◽  
Hip Screw
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