Short barrel DHS plates for the treatment of intertrochanteric hip fractures in Indian population

Abstract

Background : The dynamic hip screw has appeared to be a reliable answer for intertrochanteric fractures. Intertrochanteric fractures are composed of different anatomic patterns that vary in their degree of stability. However insufficient impaction allowed by the implant may have an adverse effect on fracture healing. Methods : One hundred and four patients were divided in two groups and followed up for one year, mean age was 78.2 years. The ninety patients in group I were fixed with short barrel plate and screws of 75mm or less while fourteen patients in group II were treated with standard barrel plate and screws of 80mm or more. Results : In patients treated with short barrel DHS four out of 90 fractures in group 1 did not heal while in group 2 one out of fourteen did not heal due to failure of standard barrel plate to accommodate the collapse of the fracture fragments. We observed a healing rate of 100% at 3 months. Conclusion : The DHS is reliable for intertrochanteric fractures. However the results of our study support the use of short barrel plates rather than standard barrel plates in Indian population with shorter femoral head and neck length to allow sufficient slide when using dynamic screws of 75 mm or less.