Intertrochanteric Fracture Treated by Dynamic Hip Screw, Aden, Yemen

Abstract

Objective: To evaluate the clinical outcomes of intertrochanteric fractures that were treated with Dynamic Hip Screw in Aden Patients and method: This was a retrospective study of patients presenting with intertrochanteric fracture, to the Department of Orthopaedic Surgery at Algamhoria Teaching Hospital and at two private hospital in Aden, Yemen, during the period January 2018–December 2019. The patients were treated with Dynamic Hip Screw (DHS). All information was obtained from the patient charts. The collected data was tabulated and statistical analysis was done by estimating rates, means and standard deviations. Fisher test was used and p-value < 0.05 was considered as statistically significant. The statistical software package SPSS version 17 was used. Results: Out of 48 patients, 29 patients were females (60.4%) and 19 patients (39.6%) were males and the mean age was 75.1±7.4 years. The mean age of male patients was 76.4 ± 6.9 years while for females was 74.2±7.7 years. The age ranged between 62 to 90 years. The patients were categorized into 3 age groups: Group (I) 70 years old, (27.1%) were females and (10.4%) were males, Group (II) from 71 – 80 years old, (20.8%) were females and (14.6%) were males. Group (III) from 81 – 90 years old, (12.5%) were females and (14.6%) were males, (p > 0.05). Causes of injury were simple fall in most of the cases (79.1%). The causes of injuries were significantly different among the age groups of patients (P < 0.05). We found (58.3%) of intertrochanteric fractures were in the right side and (41.7%) were in the left side. The stable fractures were (52.1%) while unstable fractures were (47.9%). According to Evan classifications (31.3%) of the intertrochanteric fractures were classified as Type I and (20.8%) were classified as Type II. Type III were predominant with (47.9%). Superficial stitch infection were (4.2%) and (4.2%) were deep infection. Shortening of 1-2cm occurred in (10.4%) of patients. Mal-union occurred in (20.8%) cases. Delayed union occurred in (10.4%) cases. Active physiotherapy is given regularly for delayed union. Deep vein thrombosis developed in (8.4%) of cases and pulmonary thrombosis occurred in (4.2%) of cases. Conclusion: The dynamic hip screw is a modality of choice in patients with intertrochanteric fracture; it is effective, simple, and safe. Further studies are needed to compare between our modality and other modalities. Key words: dynamic hip screw, intertrochanteric fracture, femur, Aden, Yemen