WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

( An ISO 9001:2015 Certified International Journal )

An International Peer Review Journal for Medical Science and Pharma Professionals
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Indexing

Abstract

INTERTROCHANTERIC FRACTURE COMPARISON BETWEEN DHS AND EXTERNAL FIXATION

Dr. Rabah Abdulla AL- Ebadi, F.I.C.M.S (Ortho)*, Dr. Abdulla Nataq AL-obydy, C.A.B.M.S. and
Dr. Mamoon Abdulmunem AL-Dabbagh, F.I.C.M.S

ABSTRACT

Background: Hip fractures, including intertrochanteric fractures due to falls, are one of the most common orthopedic problems in the elderly, Dynamic hip screw (DHS) fixation has been considered the gold standard for treating stable intertrochanteric fractures, the technique of closed reduction and external fixation offers an alternative. Objective: To find out the outcome of treating intertrochanteric femoral fractures and comparison between the uses of dynamic hip screw versus external fixation regarding operative time, number of x-ray shot, post-operative infection, deep vein thrombosis and the need of blood transfusion. Material and methods: A total of fifty patients, between 60 to 75 years with isolated intertrochanteric fracture neck of femur Evan’s types I and II. Divided equally into group A treated by external fixation, group B treated by dynamic hip screw during the period from January 2020 to June 2021, at Al-Jumhoori teaching hospitals with follow up period of one year . Results: Of the fifty patients thirty two were female and eighteen patients were male, with an average age of sixty six years, the fracture were distributed thirty six on left and fourteen on the right side. In Group A the results were twenty two (88%) cases whose healing was achieved and no complications were encountered. Two (8%) of the cases developed deep pin-tract infection which needed redo operation by wounding excision and changing site of schanz. One (4%) developed DVT average operative time required for external fixation was 25 minutes with average radiation exposure of 23 shots. Only two (8%) patients needed blood transfusion. In Group B twenty one (84%) patients had no post-operative complication with two (8%) patients developing DVT and two (8%) developing infection at the site of operation. One of them ended by total hip replacement and the other needed multiple operation for wound cleaning. The average operative time was 40 minutes, and the average radiation exposure was 45 shots, ten (40%) patients needed blood transfusion. Conclusion: Both approaches are simple and effective with the external fixation being more suitable for patients requiring less stressful procedures.

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