Outcome Evaluation of Intertrochanteric Fracture Fixation Using Dynamic Hip Screw

Open Access

Abstract

Background: Intertrochanteric femoral fractures are common in the elderly and often lead to significant morbidity. The Dynamic Hip Screw (DHS) is a widely used fixation method, though its outcomes continue to be evaluated in relation to fracture stability and patient factors. Aim: To assess the clinical, radiological, and functional outcomes of intertrochanteric fracture fixation using DHS and identify factors influencing postoperative recovery. Methods & Materials: This prospective study included 36 patients (mean age 75.2 ± 9.1 years) with AO/OTA 31-A1 to A3 fractures treated with DHS. Follow-up was ≥12 months. Radiological outcomes included time to union, neck–shaft angle, and fracture collapse. Functional outcomes were measured using Harris Hip Score (HHS) and SF-36 PCS. Statistical significance was set at p < 0.05. Results: Mean time to union was 13.6 ± 2.1 weeks, and mean neck–shaft angle was 129.8° ± 5.0°. Final HHS averaged 82.4 ± 10.2, and SF-36 PCS averaged 72.5 ± 11.3. Excellent or good outcomes were seen in 55.6% of patients. Younger age (<75 years), stable fracture pattern, early surgery (<3 days), and absence of complications were significantly associated with higher HHS. Complications occurred in 27.8%, including screw cut-out (5.6%), varus malunion (8.3%), and implant-related pain (11.1%). Conclusion: DHS fixation provides dependable union and satisfactory function, particularly in stable fractures and when surgery is performed early. Accurate reduction and careful postoperative care help minimize complications and improve outcomes in elderly patients.