Dynamic Hip Screw Blade Fixation for Intertrochanteric Hip Fractures

Leung, Frankie; Gudushauri, Paata; Yuen, Grace; Lau, Tak Wing; Fang, Christian; Chow, S. P.

doi:10.1177/230949901202000307

Cited by 19 publications

(15 citation statements)

References 33 publications

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“…O'Neil et al found that DHS blade has greater rotational stability than DHS [24]. Leung et al had also proven the effectiveness of DHS blade in a case series with 1% failure rate [25]. In this study, we found that DHS blade had better antidisplacement ability at CA and CC position and better antirotational ability at IC position than conventional DHS.…”

Section: Discussionsupporting

confidence: 59%

A Biomechanical Study Comparing Helical Blade with Screw Design for Sliding Hip Fixations of Unstable Intertrochanteric Fractures

Luo

Yuen

Lau

et al. 2013

The Scientific World Journal

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Dynamic hip screw (DHS) is a well-established conventional implant for treating intertrochanteric fracture. However, revision surgery sometimes still occurs due to the cutting out of implants. A helical blade instead of threaded screw (DHS blade) was designed to improve the fixation power of the osteoporotic intertrochanteric fracture. In this study, the biomechanical properties of DHS blade compared to the conventional DHS were evaluated using an unstable AO/OTA 31-A2 intertrochanteric fracture model. Fifty synthetic proximal femoral bone models with such configuration were fixed with DHS and DHS blade in five different positions: centre-centre (CC), superior-centre (SC), inferior-center (IC), centre-anterior (CA), and centre-posterior (CP). All models had undergone mechanical compression test, and the vertical and rotational displacements were recorded. The results showed that DHS blade had less vertical or rotational displacement than the conventional DHS in CC, CA, and IC positions. The greatest vertical and rotational displacements were found at CP position in both groups. Overall speaking, DHS blade was superior in resisting vertical or rotational displacement in comparison to conventional DHS, and the centre-posterior position had the poorest performance in both groups.

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Section: Discussionsupporting

confidence: 59%

A Biomechanical Study Comparing Helical Blade with Screw Design for Sliding Hip Fixations of Unstable Intertrochanteric Fractures

Luo

Yuen

Lau

et al. 2013

The Scientific World Journal

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“…It could be kept in the human body for a long time and is one of the first-choice internal fixator for clinical treatment of ITF at present [2,20]. The sliding screws and side plates of the DHS internal fixator are firmly fixed to the proximal end of the fracture with strong flexural strength, better medial support effect, thus being positive for hip fracture treatment [3,4,21]. However, in clinical application, concerning the effect of patients' ages, fracture types, reduction effects, and fixed positions, DHS fixation might bring complications such as screws breaking through the femoral head, screws cutting femoral head, coxa vara, screws loosening, and steel plates pulling out [5,[22][23][24].…”

Section: Discussionmentioning

confidence: 99%

“…Since 1970, it has been widely used globally and was refined by the Swiss Society of Internal Fixation later, with a short abbreviation as DHS. At present, DHS has been recognized as the gold standard for stable ITF treatment, with features such as firm fixation, easy-to-perform and confirmative efficiency [2][3][4]. As its wide application, some accompanying failures such as femoral head cutting, fracture translocation due to too much hip screw sliding, fracture unhealing, and injured limb shortening [5,6].…”

Section: Introductionmentioning

confidence: 99%

Autogenous fibula graft and cannulated screw fixation to cephalic cut out after DHS fixation: a retrospective study

et al. 2020

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Background: This study aimed to explore the effect of the treatment through autologous fibula graft and hollow needle fixation to treat femoral head cutting after dynamic hip screw (DHS) fixation. Methods: A total of 41 patients were admitted to the department of orthopedic trauma and received DHS fixation. Preoperative and postoperative harris score of hip function, limb shortening length and collodiaphysial angle between operation group (n = 11) and non-operation group (n = 13) were compared. Results: There was no difference between the two groups before surgery (P > 0.05). There was a difference between the preoperative and postoperative in the operation group (P < 0.05). The excellent and good rate of the hip function score in patients 6 months after the operation was 55.6%. In the operation group, the hip function score increased after surgery (P < 0.001). Except for two groups of patients before operation, there was a difference in the limb shortening length and collodiaphysial angle between the operation group and non-operation group in other time points after surgery (P < 0.001). Conclusion: The application of the autogenous fibula graft and hollow nail fixation was effective in treating femoral head cutting after DHS fixation, and patients' subjective evaluation and objective indicators' outcomes of follow up were satisfactory, which was worthy of clinical application.

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“…At the one-year follow-up, 81 patients were available, and all fractures had healed without various deformities [19]. There was one loss of fixation (1% device failure) secondary to a non-traumatic sub-capital fracture at 3 months, for which a bipolar hemi-arthro-plasty was performed.…”

Section: Screw Cutout and Device Failurementioning

confidence: 99%

An Assessment of the Relationship between Nonunion and Device Failure Following the Treatment of Intertrochanteric Fracture, by Dynamic Hip Screw (DHS) Using Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association (AO/OTA) and Dorr Classification

Torkaman¹,

Yazdi²,

Hamdollahzadeh³

et al. 2017

OJO

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Background: Intertrochanteric fractures are of intense interest globally. They are the most frequently operated fracture type, have the highest postoperative fatality rate of surgically treated fractures, and have become a serious health resource issue due to the high cost of care required after injury. A number of problems exist when determining the best option for treatment for intertrochanteric fractures. The classification systems do not work well enough for preoperative planning and the reduction criteria have not been well defined. Methods: All patients who presented to Firoozgar Hospital, Tehran with intertrochanteric fracture, between March 20th 2013 and December 21st 2015, underwent DHS implementation, after 6-month follow-up period. Demographic data, preoperative radiographic fracture, bone quality typing (AO/OTA and Dorr classification), American Society of Anesthesiologists (ASA) score and evaluation of their correlation with the complication of fixation including nonunion and device failure were recorded and analyzed. A. Torkaman et al. 3330 to 94 years; the most frequent age period was 76 -85 years, injured by low-energy trauma mechanism and 23.8% patients were injured in a highenergy trauma. 56 patients completed the 6-month follow-up evaluation which ranged from 1 to 80 weeks. According to AO/OTA classification, the most common type among the patient population was A2, 27 patients (51.5%); while the most common group from Dorr classification turned to be group B (39.6%). Classification by ASA score revealed Class II to be most frequent among the patient population (56.4%). Nonunion was seen in eight of patients (14.3%). Three patients (5.4%) had device failure, two cases showed side plate breakage, and another one had screw cut out. There was no significant relationship between AO/OTA classification with the both complications i.e. the development of device failure (P = 0.85) and nonunion (P = 0.99). Non-significant correlation was found between Dorr classification with device failure (P = 0.06) and nonunion (P = 0.11). Conclusion: Regarding recent studies, more effective factor on the outcome is patient's medical condition before surgery compared to the radiographic findings including AO/OTA and Dorr classification.

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Dynamic Hip Screw Blade Fixation for Intertrochanteric Hip Fractures

Cited by 19 publications

References 33 publications

A Biomechanical Study Comparing Helical Blade with Screw Design for Sliding Hip Fixations of Unstable Intertrochanteric Fractures

A Biomechanical Study Comparing Helical Blade with Screw Design for Sliding Hip Fixations of Unstable Intertrochanteric Fractures

Autogenous fibula graft and cannulated screw fixation to cephalic cut out after DHS fixation: a retrospective study

An Assessment of the Relationship between Nonunion and Device Failure Following the Treatment of Intertrochanteric Fracture, by Dynamic Hip Screw (DHS) Using Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association (AO/OTA) and Dorr Classification

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