title: Comparison of intertrochanteric fracture fixation with dynamic hip screw and bipolar hemiarthroplasty techniques.
abstract: BACKGROUND
  At present, there is no consensus on an appropriate treatment modality for intertrochanteric fractures in the elderly with background diseases. The aim of the present study was to compare treatment outcomes of intertrochanteric fractures reduced with dynamic hip screws (DHS) and bipolar hemiarthroplasty in elderly patients with background medical conditions.
  
  
  METHODS
  In this randomized clinical trial, 60 patients with intertrochanteric fractures, who were 45-60 years old, were randomly divided into DHS and bipolar groups. After treatment, the two groups were compared in relation to complications and mortality rates, functional status using the Harris Hip Score (HHS), range of movement and severity of pain using the visual analogue score (VAS).
  
  
  RESULTS
  HHS (86±9 vs. 75±7.6), range of flexion (105±11 degrees vs. 90±17 degrees) and external rotation (35±7 degrees vs. 20±7 degrees) were significantly higher in the bipolar group compared to the DHS group (P<0.05). However, there were no significant differences in pain severity between the two groups.
  
  
  CONCLUSIONS
  Reduction of intertrochanteric fractures in elderly patients with background medical conditions is more effective and less problematic with the bipolar technique compared to DHS and is better tolerated by patients, because this technique is associated with improvements in functional status and hip joint movement range.
authors.affiliation: Mohamad Emami MD, Ali Reza Manafi MD, Behrooz Hashemi MD, Ali Nemati MD, Saeed Safari MD, Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Emami
authors.affiliation: Mohamad Emami MD, Ali Reza Manafi MD, Behrooz Hashemi MD, Ali Nemati MD, Saeed Safari MD, Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Manafi
authors.affiliation: Mohamad Emami MD, Ali Reza Manafi MD, Behrooz Hashemi MD, Ali Nemati MD, Saeed Safari MD, Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Behrooz
authors.initials: B
authors.lastname: Hashemi
authors.affiliation: Mohamad Emami MD, Ali Reza Manafi MD, Behrooz Hashemi MD, Ali Nemati MD, Saeed Safari MD, Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Nemati
authors.affiliation: Mohamad Emami MD, Ali Reza Manafi MD, Behrooz Hashemi MD, Ali Nemati MD, Saeed Safari MD, Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Safari
keywords: Bipolar hemiarthroplasty; Dynamic hip screw; Intertrochanteric fracture