Role of Variable Angle Hip Screw in Trochanteric Fracture of Femur: A Prospective Study

ABSTRACT

Objective: To assess the functional outcome (clinical andradiological) of Variable angle hip screw (VHS) in trochantericfractures of femur.Materials and Methods: The study comprised of 30 patients,with follow up at regular intervals. According to Jensen andMichaelsen’s modification of Evan’s classification, 16 patientswere of stable patterns and 14 were of unstable patterns.Parameters which were evaluated during folow-up includedtime to partial weight bearing, time to full weight bearing,radiological union, mobility of the patient at 3 months and at 6months postoperatively.Results: Duration of surgery was <50 min in 14(46.7%)patients, 51-60 min in 11 (36.7%) patients in and >60 min in 5(16.6%) patients. Mean duration of surgery was 55 min. Rangeof duration of surgery was 48-78 min. In both stable andunstable fractures, majority of patients achieved partial weightbearing at 3-4 weeks and full weight bearing at 14-16 weeksand the difference was not significant. For Unstable groupRadiological union was achieved after 14 weeks in 50% ofpatients whereas in Stable group all patients achievedradiological union before 14 weeks and the difference wasstatistically significant (X2=12.293, df=3, p=0.008). Nosignificant difference was found among both the groups inmobility at 3 months and at 6 months. According to ModifiedSchatzker-Lambert score done at 6 months after surgery;excellent result occurred in 23 cases (76.7%) , good resultoccurred in 5 cases (16.7%),fair result occurred in 2 cases(6.6%)Difference in Modified Schatzker- Lambert Score forboth groups was statistically significant (X2=7.028, df=2,p=0.03).Conclusion: Variable angle hip screw (VHS) can beconsidered an effective method of treating trochantericfractures in terms of functional outcome.