Dynamic hip screw in the treatment of intertrochanteric fractures: a comparison of two fixation methods

The study is a prospective evaluation and comparison. A minimally invasive Dynamic Hip Screw (MIDHS) technique is presented. One hundred and two patients with intertrochanteric fractures were treated with either a MIDHS or a conventional dynamic hip screw (CDHS). We used the Singh index as a measure of osteoporosis and also classified the fractures according to three different systems (OTA, Boyd-Griffin, and Evans). All patients were followed up for 12 months with a hip score evaluation. The patients were divided into two groups, based on the method of treatment. The MIDHS group includes 42 patients with an average age of 72.6 years. The CDHS group includes 60 patients, with an average age of 71.3 years. Both groups were similar in injury mechanism, fracture types, mean Singh index and confounding medical condition (all p values >0.05). The CDHS group had significantly larger wound incision, greater haemoglobin level drop, higher pain level, more total analgaesic use and longer hospital stay than the MIDHS group (all p values<0.05). The hip score, union rate, healing time, adequate reduction and adequate screw position rate was not significantly different between the two groups (all p values >0.05). In conclusion, either a MIDHS or a CDHS in the treatment of intertrochanteric fractures is an effective, simple and safe method. The mini-invasive technique as opposed to the conventional technique has smaller wound size, lower pain level, and lower blood loss. Hospital stay and total analgaesic use were decreased, benefitting the patient and reducing hospital cost.