Treatment of intertrochanteric femoral fractures with minimally invasive dynamic hip screws / 中华创伤杂志

ABSTRACT

Objective To evaluate effects of minimally invasive dynamic hip screw(DHS)in treatment of intertrochanteric femoral fractures.Methods The study involved 98 patients with intertrochanteric femoral fractures treated by closed reduction and C-arm fluoroscopy guided minimally invasive DHS from January 2004 to January 2010.According to AO classification,there were 38 patients with type A1 fractures and 60 with type A2 fractures.According to Evans classification,there were nine patients with typeⅠ?fractures,29 with type Ⅱ,36 with typeⅢ?and 24 with type V.Intraoperative blood loss,operation time and incision length were recorded.Results The intraoperative hemorrhage,operation time and incision length were average 250 ml(range,150-450 ml),54.3 minutes(range,45-70 minutes),and 5.2 cm(range,4-7 cm),respectively.All the patients were followed up for 12-38 months(mean 16.8 months).Fracture healing time was 10-14 weeks(average 11.5 weeks).According to Zuekerman functional scoring for hip joint,the results were excellent in 61 patients,good in 30,fair in four and poor in three,with excellence rate of 92.9％.Varus deformity of hip occurred in four patients.No patient presented surgical site infection,implant failure or displacement of fractures.Conclusion Minimally invasive DHS is an effective means in treating intertrochanteric femoral fractures,but the key point of successful treatment is to strictly grasp the correct operative procedures.