title: [Complications of surgical treatment for femoral intertrochanteric fractures using dynamic hip screw].
abstract: 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.
authors.affiliation: Department of Orthopedics, Navy General Hospital of PLA, Beijing 100037, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.forename: Peng-jian
authors.initials: PJ
authors.lastname: Wang
authors.forename: Di-ke
authors.initials: DK
authors.lastname: Ruan
authors.forename: Qing
authors.initials: Q
authors.lastname: He
authors.forename: Yu
authors.initials: Y
authors.lastname: Ding
authors.forename: Li-sheng
authors.initials: LS
authors.lastname: Hou
authors.forename: Yi-zhou
authors.initials: YZ
authors.lastname: Wang
mesh_terms: 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