A Randomised Study on Outcome of Dynamic Hip Screw Fixation versus Helical Hip Screw System in Intertrochanteric Fracture

Abstract

Introduction: Trochanteric fractures occur in the young population due to high velocity trauma, whereas in the elderly population, it is most often due to trivial trauma. In the United States 49% of the hip fractures are intertrochanteric. The most commonly used devices for fixation is the Dynamic Hip Screw with Side Plate assemblies. We aimed to compare the outcome of dynamic hip screw fixation versus helical hip screw system in intertrochanteric fracture. Methods: A prospective study was conducted at our institution. A total of 25patients with comparable characteristics in each the DHS group and the spiral blade plate group were selected for the study, randomizing them into the 2 groups for comparison. Radiological outcome on the basis of union, complications with respect to implant cut-out and malalignment and functional outcome on the basis of Harris Hip Score were recorded.Results: The mean time taken for surgery in the DHS group (in mins) mean was 57.44(SD±9.305), and in the DHHS group mean was 48.44(SD± 6.740). There was significant statistical difference (p=0.00014). Time taken for union was insignificant (p=0.399). At 6 months mean Harris Hip Score statistically had no difference (p=0.288). There was no failure or complication in both groups. Conclusion: Although the mean operative time was almost 10 mins more in the DHS group, there is no statistically significant difference in the functional outcome between the DHS group and DHHS group. Key to success is maintaining the Tip-apex distance to within 25 mm, consistent with the Bauemgarter series with the DHS.