Comparing the outcomes of fixation of Intertrochanteric Fractures with the dynamic hip screw (DHS) using Conventional and Minimal Invasive Technique

Authors

  • Mudassir Hussain SMBBC
  • Akhter Baig Department of Orthopedic Surgery, Lyari General Hospital
  • Farrukh Hussain Department of Orthopedic Surgery, Jinnah Postgraduate Medical Center
  • Nuvair Zia Dow University of Health Sciences, Civil Hospital
  • Ibtisam Indus Hospital

Abstract

Objective

To compare the outcome of standard DHS technique through minimal invasive approach versus conventional technique among patient attending with intertrochanteric fracture.

Methods: Quasi experimental prospective study from 1st March 2018 to 28th November 2021. The study was conducted at Lyari General Hospital, Karachi-Pakistan from 1st March 2018 to 28th November 2021 under spinal anesthesia. All patients with intertrochanteric fracture aged greater than 60 years having surgeries performed within 3 weeks of injury were included. A total of 120 patients were included which were equally divided in MIDHS by conventional group. Outcome variables like operating time, blood loss, post-operative decrease in hemoglobin, hospital stay, pain score, early mobilization, Harris Hip score at 6 and 12 weeks and complications were noted.

Results: Of 120 patients, a significantly lower operating time (in mins) (p-value <0.001, 95% CI -34.29 to -28.89), blood loss (in ml) (p-value <0.001, 95% CI -32.02 to -16.65), post-operative decrease in hemoglobin (in g/dL) (p-value <0.001, 95% CI -3.43 to -2.88), hospital stay (in days) (p-value 0.002, 95% CI 1.25 to -0.28), pain score (p-value <0.001, 95% CI -2.43 to -2.16), Harris Hip score at 6 weeks (p-value <0.001, 95% CI 2.97 to 5.79), and 12 weeks  (p-value 0.015, 95% CI 0.18 to 1.62) was found in MIDHS group as compared to conventional group. Moreover, early mobilization was found significantly higher in MIDHS group as compared to the conventional group, i.e., 35 (58.30%) and 22 (37%) respectively.

Conclusion: The finding of this study has showed that MIDHS is good technique with fewer complications of inter-trochantric fractures fixation.

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Published

2023-03-06