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

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.