[Application of dynamic hip screw with modified reamer in intertrochanteric fracture in the elderly].

OBJECTIVE

To investigate the therapeutic effect and characteristic of dynamic hip screw with modified reamer (MDHS for short) in the treatment of the intertrochanteric fracture in the elderly.

METHODS

Fifty-four patients with intertrochanteric fracture from Aug. 2007 to Dec. 2008 were retrospectively analyzed. Among them, 27 patients were treated with MDHS, including 12 males and 15 females with an average age of 79.4 years old ranging from 69 to 93 years; according to modified Evans classification, there were 3 cases of type I , 12 cases of type II, 8 cases of type III, 4 cases of type IV. The other 27 patients (10 males and 17 females), aged from 66 to 88 years old (average 77.2), were composed of 4 cases of type I, 14 cases of type II, 6 cases of type III, 3 cases of type IV. The fracture healing time,forepart movement time,percentage of loosening screw and hip joint function were compared between two groups.

RESULTS

All 54 patients were followed up for 21 to 36 months (means 27.6 months). All fractures were bone healing. The time of fracture healing were compared between two groups,there were no significant difference (P>0.05). The forepart movement time of MDHS group (14.2 +/- 2.1) was shorter than that of DHS group (18.9 +/- 3.1) (P<0.05). The loosening screw of MDHS group (1 case) was less than that of DHS group (8 cases) (P<0.05). The Harris score of hip joint function of MDHS group (87.8 +/- 4.7) was higher than that of DHS group (83.3 +/- 7.5) (P<0.05).

CONCLUSION

MDHS has several advantages on wider indications, stronger holding power,early forepart movement time, fewer complications, which is a good choice for osteoporotic intertrochanteric fracture.