Clinico-radiological results of unstable trochanteric fractures treated with custom-made trochanteric stabilisation plate and dynamic hip screw (DHS)
Journal Title: International Journal of Orthopaedics Sciences - Year 2018, Vol 4, Issue 3
Abstract
Aim: To evaluate the clinico-radiological results of implantation of Custom-made Trochanteric stabilisation plate (TSP) along with Dynamic Hip Screw (DHS) in unstable trochanteric fractures and assess whether it prevents complications such as excessive collapse and femoral medialization. Materials and Methods: 58 consecutive patients with unstable intertrochanteric fractures (AO CLASSIFICATION) were treated with an additional custom-made TSP superimposed on the regular DHS at our institution between JAN 2012 TO DEC 2015.9 patients did not turn up for regular follow-up. Thus, 49 patients were followed-up for a period of 6 months. Patients were assessed clinically using Harris His Score and Salvati-Wilson score at each follow-up. Results: Excessive collapse and medialization of femur were successfully prevented in 49 patients. Clinico-radiological consolidation of fracture was observed at an average of 15.23 weeks in all the cases. The average sliding distance was 7.3 mm.38 patients had a Harris Hips Score (HHS) of above 90 at the final follow up and the rest had a HHS of above 80. Functional results were excellent in 88 percent of patients and good in the rest 12 percent according to Salvati- Wilson score. Conclusion: In unstable intertrochanteric fractures with lateral wall comminution, the use of our custom-made TSP along with DHS helps in achieving a stable fixation and prevents complications such as excessive collapse and femoral medialization. Custom-made TSP is easily available and is a cost-effective alternative for anatomical TSP.
Authors and Affiliations
Dr. D Thulasi Raman, Dr. Arul Vignesh, Dr. Siva Swaminathan
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