N Acar1,2, A Harb3, A Albaya3, H Kaskin3. 1. Department of Orthopaedics and Traumatology, Al-shifa Medical Complex, The Surgery Hospital, Gaza strip, 79702, Gaza, Palestine. eyad55_55@yahoo.com. 2. Department of Orthopaedics and Traumatology, Ozel Gazikent medical center, Gazi emir, 35410, Izmir, Turkey. eyad55_55@yahoo.com. 3. Department of Orthopaedics and Traumatology, Al-shifa Medical Complex, The Surgery Hospital, Gaza strip, 79702, Gaza, Palestine.
Abstract
PURPOSE: Hip intertrochanteric fractures are very frequent. Early mobilization reduces the associated mortality and morbidity rate. DHS is still commonly used in many centers. We describe a new minimal invasive DHS technique (MIDHS) depending on radiological land marks, facilitating the application of DHS in a proper way without the use of an angle guide and we retrospectively compared the functional results of the new technique with that of the conventional DHS (CDHS) technique. METHODS: 116 patients (MIDHS n = 56; CDHS n = 60) with stable intertrochanteric fractures were followed up for at least 12 months. The motoric function using the Barthel index, the post-operative pain using the VAS, and the time of bone healing of the new MIDHS group were compared to that of the CDHS group. RESULTS: The 1st, 2nd, 3rd, 7th, 15th, and 45th days showed a higher motoric function of the MIDHS compared with the CDHS, P (0.001, 0.032, 0.012, 0.001, 0.028 and 0.041), respectively. VAS demonstrated less scores of the MIDHS group in the 1st, 2nd, 3rd, 7th, 15th, and 45th days when compared with that of the CDHS group, P (0.001, 0.032, 0.012, 0.001, 0.028, and 0.041), respectively. However, no statistical significance was detected in bone-healing time between the two groups. CONCLUSIONS: The new MIDHS technique is a trustable procedure that may help the surgeon to perform DHS fixation in a proper way. It offers a better motoric function, less pain. However, further studies should be conducted to evaluate the validity of such radiological land marks in proximal femoral surgery.
PURPOSE: Hip intertrochanteric fractures are very frequent. Early mobilization reduces the associated mortality and morbidity rate. DHS is still commonly used in many centers. We describe a new minimal invasive DHS technique (MIDHS) depending on radiological land marks, facilitating the application of DHS in a proper way without the use of an angle guide and we retrospectively compared the functional results of the new technique with that of the conventional DHS (CDHS) technique. METHODS: 116 patients (MIDHS n = 56; CDHS n = 60) with stable intertrochanteric fractures were followed up for at least 12 months. The motoric function using the Barthel index, the post-operative pain using the VAS, and the time of bone healing of the new MIDHS group were compared to that of the CDHS group. RESULTS: The 1st, 2nd, 3rd, 7th, 15th, and 45th days showed a higher motoric function of the MIDHS compared with the CDHS, P (0.001, 0.032, 0.012, 0.001, 0.028 and 0.041), respectively. VAS demonstrated less scores of the MIDHS group in the 1st, 2nd, 3rd, 7th, 15th, and 45th days when compared with that of the CDHS group, P (0.001, 0.032, 0.012, 0.001, 0.028, and 0.041), respectively. However, no statistical significance was detected in bone-healing time between the two groups. CONCLUSIONS: The new MIDHS technique is a trustable procedure that may help the surgeon to perform DHS fixation in a proper way. It offers a better motoric function, less pain. However, further studies should be conducted to evaluate the validity of such radiological land marks in proximal femoral surgery.
Entities:
Keywords:
Clinical results; Intertrochanteric fracture; New minimal invasive DHS technique
Authors: Katrine A Nielsen; Niels C Jensen; Claus M Jensen; Marianne Thomsen; Lars Pedersen; Søren P Johnsen; Annette Ingeman; Paul D Bartels; Reimar W Thomsen Journal: BMC Health Serv Res Date: 2009-10-12 Impact factor: 2.655