Mini-incision dynamic hip screws fixation for treatment of femoral intertrochanteric fractures in the elderly / 中国矫形外科杂志

ABSTRACT

[Objective]To explore the surgical technique and clinical results of minimally invasive incision dynamic hip screws (DHS) in treatment of intertrochanteric fractures in the elderly.[Method]From August 2001 to January 2006,37 old cases (15 males and 22 females, aged from 72 years to 92 years, mean 81.5 years) with intertrochanteric fractures were treated with closed reduction and DHS using minimally invasive technique in our hospital. The procedure included following and critical steps:1～2 k-wires was inserted into the upper part of the femoral head through great trochanter percutaneously after operation. A guide wire was inserted into the center of the femoral head according to 135? collodiaphyseal angle; then, a small incision (4～5.5 cm) was made and along the guide wire for inserting a screw into the femoral head. The guide wire was removed and the side plate was slipped under the soft tissue into to tightly contact the lateral surface of femur, and followed by the side plate barrel being seated on the screw.[Result]The operation time was 40～75 minutes (average 60 minutes) The mean amount of blood loss in, operation was 55 ml. The mean amount of hemoalehin showed no significant difference between postoperation and preoperation. The following-up period averaged 15 months (11～18 months) The clinical hone healing lasted for 10～15 weeks. Two cases had mild coxa vara, there were no incision infection, fixation failure or lower extremity rotatory deformity. The excellent rate of joint function was 94.6% according to DONG's assay standard. [Conclusion]Minimally invasive incision DHS has the advantages of shorter operation time, less blood loss, little trauma, less complications and quick functional recovery and is an effective and safe method for treatment of femoral intertrochanteric fractures in the elderly.