The clinical results of a novel method for minimal invasive dynamic hip screw fixation of intertrochanteric fractures compared to the conventional one.
OBJECTIVE
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.
Department of Orthopaedics and Traumatology, Al-shifa Medical Complex, The Surgery Hospital, Gaza strip, 79702, Gaza, Palestine. eyad55_55@yahoo.com.|Department of Orthopaedics and Traumatology, Ozel Gazikent medical center, Gazi emir, 35410, Izmir, Turkey. eyad55_55@yahoo.com.
N
N
Acar
Department of Orthopaedics and Traumatology, Al-shifa Medical Complex, The Surgery Hospital, Gaza strip, 79702, Gaza, Palestine.
A
A
Harb
Department of Orthopaedics and Traumatology, Al-shifa Medical Complex, The Surgery Hospital, Gaza strip, 79702, Gaza, Palestine.
A
A
Albaya
Department of Orthopaedics and Traumatology, Al-shifa Medical Complex, The Surgery Hospital, Gaza strip, 79702, Gaza, Palestine.
H
H
Kaskin
D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D004434:Early Ambulation; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010149:Postoperative Pain; D011183:Postoperative Complications; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome
Clinical results; Intertrochanteric fracture; New minimal invasive DHS technique