Sliding hip screw versus sliding helical blade for intertrochanteric fractures: a propensity score-matched case control study

The Bone & Joint Journal
Christian FangF Leung

Abstract

The spiral blade modification of the Dynamic Hip Screw (DHS) was designed for superior biomechanical fixation in the osteoporotic femoral head. Our objective was to compare clinical outcomes and in particular the incidence of loss of fixation. In a series of 197 consecutive patients over the age of 50 years treated with DHS-blades (blades) and 242 patients treated with conventional DHS (screw) for AO/OTA 31.A1 or A2 intertrochanteric fractures were identified from a prospectively compiled database in a level 1 trauma centre. Using propensity score matching, two groups comprising 177 matched patients were compiled and radiological and clinical outcomes compared. In each group there were 66 males and 111 females. Mean age was 83.6 (54 to 100) for the conventional DHS group and 83.8 (52 to 101) for the blade group. Loss of fixation occurred in two blades and 13 DHSs. None of the blades had observable migration while nine DHSs had gross migration within the femoral head before the fracture healed. There were two versus four implant cut-outs respectively and one side plate pull-out in the DHS group. There was no significant difference in mortality and eventual walking ability between the groups. Multiple logistic regression suggeste...Continue Reading

References

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Citations

Mar 31, 2016·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Senthil Nathan SambandamCyril Mauffrey
Jul 20, 2019·Geriatric Orthopaedic Surgery & Rehabilitation·Young Lu, Harmeeth S Uppal

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