[Complications of intertrochanteric fracture treated with dynamic hip screw: cause analysis and prevention]

To analyze causes of the complications in treatment of the intertrochanteric fractures with dynamic hip screw (DHS) and discuss the way of the prevention.

Sixty-five cases of intertrochanter fractures of femur were treated with DHS. Among them, the complications occurred in 13 cases, their causes were analyzed and corresponding preventive treatments were discussed. The patients with complications included 8 male and 5 female, and the mean age was 70.2 years (range, from 56 to 82 years).

The major complications of 13 cases included proximal femoral cortex broken in 2 cases, femoral heads penetrated by screw in 2,varus deformity of hip in 5, necrosis of femoral head in 1, the wound infection in 3 (including bone non-union in 1).

The main causes of the complications are various as follows: the nonstandard operative procedure, incorrect aseptic measures, unsatisfactory reduction, and too early weight bearing. Therefore, appropriate preventive measures such as correct aseptic manipulation, effective treatment of general medical illness,formal operative procedure good reduction, proper fixation of lesser trochanter and posteromedial bone fragment, and correct functional training program should be taken.