Journal of Isfahan Medical School

Journal of Isfahan Medical School

Comparison of the Results of Fixation of Reverse-Oblique Intertrochanteric and Short-Segment Subtrochanteric Fractures Using Dynamic Hip Screw (DHS) and Dynamic Condylar Screw (DCS)

Document Type : Original Article (s)

Authors
Ali Andalib 1
Iman Delavary 2
Ali Mehrabi-Koushki 3
1 Associate Professor, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Resident, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Epidemiologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: In intertrochanteric fractures, dynamic hip screw (DHS) is the most frequently used tool, but several studies did not give good results for this device in reverse-oblique and transverse fractures. Current study aimed to compare fixation results of reverse-oblique intertrochanteric and short-segment subtrochanteric fractures using dynamic condylar screw (DCS) and DHS in patients referred to Alzahra and Kashani Hospitals in Isfahan, Iran.Methods: In a cross-sectional study, medical files of the patients referred to emergency units of the two hospitals who were diagnosed with intertrochanteric or subtrochanteric fractures and underwent DHS or DCS surgery more than 6 months before were assessed; they were invited for follow-up visit and examination. Written consent forms were taken from all the patients upon their entry; and they were examined in terms of complications including nonunion and failure of device and level of fracture improvement. These cases were evaluated by simple radiography, too. Results obtained from examination of patients in addition to demographic information were recorded in the data collection form for each patient.Findings: Perfect union was observed in 14 (of 25) patients in DHS group and 21 (of 25) patients in DCS group (56% vs. 84%) six months after the surgery. Bone union was significantly better in DCS group (P = 0.031). In addition, six months after the surgery, the devices used in 14 people in DHS group and 24 people in DCS group were fixed and the difference between the two groups was significant (P = 0.001). 14 and 24 patients had total recovery in DHS and DCS groups, respectively (20% vs. 44%) with a significant difference (P = 0.020).Conclusion: Considering obtained results, it can be concluded that using DCS is recommended over DHS due to severity of pain, bone union and fixation of the device.
Keywords
Intertrochanteric
Fracture
Union
Dynamic hip screw (DHS)
Dynamic condylar screw (DCS)
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Journal of Isfahan Medical School
Volume 34, Issue 395 - Serial Number 395
July and August 2016
Pages 952-957

  • Receive Date 01 November 2015
  • Accept Date 06 April 2022