[Complications of surgical treatment for femoral intertrochanteric fractures using dynamic hip screw].
OBJECTIVE
To investigate the complications of surgical treatments for femoral intertrochateric fractures using dynamic hip screw (DHS).


METHODS
From Jan. 2002 to Dec. 2007, sixty-nine patients with intertrochanteric fractures were treated by dynamic hip screw fixation included 27 males and 42 females,with an average age of 72.9 years ranging from 53 to 96 years. According to Evans classification there were 10 cases in type I ,21 in type II, 22 in type III, and 16 in type IV, of which 51 patients (73.9%) suffered from systematic diseases preoperatively.


RESULTS
Fifty-seven patients were followed up for 8 to 70 months (41 months on average). Four patients died, 17 cases occurrenced systematic complications postoperatively. Internal fixation related complications occurred in 12 patients. There were 8 cases with mechanical failure of DHS including 4 of screw loosen,3 of cutting-out of device through femoral head and neck and 1 of plate breakage. Five patients had a coxa vara, and delayed union occurred in 4 patients.


CONCLUSIONS
Unstable fracture pattern produced high percentage of mechanical failure. In such cases DHS should not be the first choice for treatment. The appropriate treatment should be in relation to pre-operative fracture stability and osteoporosis.
Zhang
Chao
C
Department of Orthopedics, Navy General Hospital of PLA, Beijing 100037, China.
Wang
Peng-jian
PJ
Ruan
Di-ke
DK
He
Qing
Q
Ding
Yu
Y
Hou
Li-sheng
LS
Wang
Yi-zhou
YZ
D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies