Dynamic Hip Screw Blade Fixation for Intertrochanteric Hip Fractures

Abstract

Purpose. To assess the one-year outcome of a dynamic hip screw (DHS) blade in the treatment of AO/OTA 31-A1 and 31-A2 intertrochanteric hip fractures. Methods. 35 men and 65 women aged 47 to 100 (mean, 83) years underwent fixation with a DHS blade for A1 (n=47) and A2 (n=53) intertrochanteric hip fractures after a low-energy injury. Patients were operated on within 48 hours of admission. Anteroposterior and lateral radiographs were examined for the tip-apex distance and femoral shortening. Potential complications were looked for, including implant migration, cut-out, loosening, or breakage. Functional outcome was based on the Parker mobility score. Results. The 30-day and one-year mortality rates were 5% and 20%, respectively. At the one-year followup, 81 patients were available, and all fractures had healed without varus deformity. The mean tip-apex distance was 14.1 (range, 5.7–31.1; SD, 4.3) mm. The mean femoral shortening was 4.9 (range, 0–20.2; SD, 4.8) mm. The mean Parker score decreased to 3.8 at one-year follow-up from 5.9 before injury (p<0.001). There was one loss of fixation secondary to a nontraumatic subcapital fracture at 3 months, for which a bipolar hemiarthroplasty was performed. Conclusion. The DHS blade system is effective in treating AO/OTA 31-A1 and 31-A2 intertrochanteric hip fractures and results in a low complication rate.