• Langenbecks Arch Chir Suppl Kongressbd · Jan 1996

    Comparative Study

    [Extra-articular proximal femur fracture in the elderly--dynamic hip screw or intramedullary hip screw for fracture management?].

    • R Wagner, A Weckbach, U Sellmair, and T Blattert.
    • Abteilung für Unfallchirurgie, Chirurgische Universitätsklinik, Würzburg.
    • Langenbecks Arch Chir Suppl Kongressbd. 1996 Jan 1;113:963-6.

    AbstractOver a 6-year period we treated 119 pertrochanteric fractures using dynamic hip screws (DHS). During the following 3 years we stabilized 112 per-, sub- and intertrochanteric, as well as "trochanter-associated" fractures by means of intramedullary hip screws (IMHS) or gamma nails (GN). Within comparable patient groups we encountered the following complications: DHS vs IMHS/GN: secondary varus malalignment of the collum femoris with "cut out": 1.7% vs. 1.8%; secondary varus malalignment without "cut out": 0.8% vs. 1.8%; infections: 5.0% vs. 2.7%; hematomas needing revision operations: 2.5% vs. 0%; torn out plate: 1.7% vs. 0%; intraoperative fissures of the shaft: 0% vs. 1.8%; intraoperative perforations of the shaft: 0% vs. 0.9%. Thus, the rate of reoperation for complications within the DHS series was 11.8%, while the rate within the IMHS/GN series was 6.3%. For stable pertrochanteric fractures we therefore acknowledge DHS as the ideal implant in our opinion, while for all other extraarticular proximal fractures of the femur we recommend IMHS or GN.

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