An Interventional Study to Know the Outcome Of Trochanteric Fracture of the Femur Treated With Dynamic hip Screw Using Harris Hip Score

Abstract

Background and Objectives: ABSTRACT Trochanteric Fractures are the most common fractures encountered by an orthopaedic surgeon accounting for a good percentage of all fractures admitted. In elderly patients usually have associated diseases like hypertension, COPD and central nervous system disorders. Such patients do not tolerate treatment with prolonged recumbency. If treated with skeletal traction, mortality and morbidity become high. They develop pneumonia, bedsores, deep vein thrombosis, muscle wasting and joint stiffness. And once skeletal traction is removed, they develop coxa vara with shortening of limbs. In this work, an attempt has been made to evaluate mechanism of injury, time delay in surgery resulting in complications, time of fracture union, effect of age and sex, outcome depending on fracture pattern, post-operative complications. Methodology: A prospective study, including 30 cases done in January 2009 to December 2009. The cases were followed up for 6 months at intervals of 6 weeks, 3 months and 6 months. All required routine investigations done pre-operatively. Study performed after obtaining consent of the patients. The Data analysis done for a period of 3 months using rates, ratios and Percentages of different outcomes as per HARRIS HIP SCORE, which will be computed and compiled. Results: At follow up of 6 months 10 patients had excellent results 16 had good results, 3 fair, and 1 had poor results. Achieved Excellent to good results of 86.67% with an Average Harris Hip Score of 85.40 points. No revision surgery done for any of the patients. 5 patients had superficial wound infection post operatively managed with antibiotics and regular dressings. For all the patients physiotherapy was started. iii Conclusion and Interpretation: After treating 30 patients we conclude dynamic hip screw with barrel plate has better advantage in terms of stability, mobility, range of motion and functional outcome. This is also the observation of many authors in contemporary orthopaedic practice as reviewed from review of literature.