Dynamic hip screw fixation of intertrochanteric fractures without using traction table

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Surgical Techniques

Background:

• Dynamic hip screw (DHS) fixation is a common procedure for hip fractures.
• Traditional DHS fixation often requires a traction table, which can be cumbersome and time-consuming.
• Alternative techniques are sought to improve efficiency and patient outcomes.

Purpose of the Study:

• To evaluate a novel technique for Dynamic hip screw (DHS) fixation that avoids the use of a traction table.
• To assess the efficacy and safety of manual traction during DHS fixation.

Main Methods:

• A retrospective evaluation of 328 patients undergoing DHS fixation using a manual traction technique between July 2006 and July 2012.
• Key metrics assessed included Tip-Apex Distance (TAD), quality of fracture reduction, operation time, and preoperative preparation time.
• Screw cutout rate was a primary safety endpoint.

Main Results:

• Good to moderate fracture reduction was achieved in 97% of cases.
• The mean Tip-Apex Distance (TAD) was 19.2 mm.
• The mean operation time was 37 minutes, with a low screw cutout rate of 0.91%.

Conclusions:

• Dynamic hip screw (DHS) fixation without a traction table using manual traction is a safe, effective, and reproducible technique.
• This method preserves reduction alignment and screw positioning while being cost-effective.
• It offers significant advantages, particularly for polytrauma patients requiring multiple surgical interventions.