COMPARISON OF TREATMENT OF UNSTABLE INTERTROCHANTERIC FRACTURES BY INTRA AND EXTRAMEDULLARY IMPLANTS IN AL HADRA HOSPITAL nagrary@gmail.com

 

COMPARISON OF TREATMENT OF UNSTABLE INTERTROCHANTERIC FRACTURES BY INTRA AND EXTRAMEDULLARY IMPLANTS IN AL HADRA HOSPITAL

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Rwanda

Oral only

To achieve union and restore the normal biomechanics of the hip region after unstable trochanteric fractures, surgical intervention is a must. There are two options for internal fixation: extramedullary and intramedullary. Dynamic hip screw (DHS) as extramedullary fixation is widely used to surgically treat intertrochanteric fractures.

This is a retrospective study of 40 patients with recent unstable intertrochanteric fractures between January 2020 and December 2020. And we compared the varieties of measures of success between these two treatments including union, lack of infections and other complications.

The mean age for group I was 50.05 (20- 83years) and the mean age for group II was 60.5 (22-91 years). 14 patients from group I were males and 12 from group II were males. All fractures were classified according to Evan’s classification to be unstable (Evan’s type III, IV, V). 19 patients (95%) of group I achieved full union and 1 patient had nonunion with nail breakage. No patients in group I had malunion. 17 patients (85%) of group II achieved good union with 1 patient having nonunion with implant failure. 2 patients (10%) of group II had femoral shaft medialization and Varus malunion.

It is concluded that this study supported the previous series in the literature, which proved that unstable intertrochanteric fractures can be fixed by intramedullary gamma nail or extramedullary DHS but intramedullary fixation gives better results than extramedullary fixation.