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

Abstract
Background: Intertrochanteric femoral fractures are com-mon in elderly patients. If they are not adequately treated, they may cause a considerable change in the quality of life. The goal of operative treatment is strong and stable fixation of the fracture fragments in which the Dynamic Hip Screw (DHS) serves as the standard and is the most common device for fixation of intertrochanteric femoral fracture.
Aim of Study: To analyze failure of Dynamic Hip Screw fixation in treatment of simple intertrochanteric fracture femur in the elderly.
Study Design and Setting: A prospective and retrospective randomized clinical trial in a tertiary care center.
Patients and Methods: This study was carried out on 50 patients with simple intertrochantric fracture femur fixed by Dynamic Hip Screw assessed clinically by Hip Harris Score (HHS) and radiologically by Tip Apex Distance (TAD), Lag screw position in femoral neck,changes occurred in fracture position and healing of the fracture.
Results: There was highly statistically significant changes of proximal femoral morphology leading to unsatisfactory results of clinical Hip Harris Score (HHA).
Conclusion: The Dynamic Hip Screw (DHS) device is the implant of choice in stable intertrochanteric fractures, and Restoration of normal proximal femur morphology give the best clinical results of DHS in fixation of intertrochanteric fractures.