Abstrac
Functional Outcome of Intertrochanteric fracture with Dynamic Hip Screw in Elderly (January – Agustus 2015)
A Case Series
Agus Eka Wiradiputra* Cok Gede Darmayuda**
*Resident of Orthopedic and Trauma, Faculty of Medicine Udayana University, Sanglah Hospital
**Orthopaedic and Traumatology Senior, Udayana University, Sanglah General Hospital Denpasar
Introduction
The incidence of Intertrochanteric femoral fractures has increased significantly in recent years and is expected to continue to rise with increasing life expectancy of elderly patients. Medical comorbidities and ambulatory status play a significant role in surgical treatment options and patient outcomes. The general goal of surgical management is to restore functional anatomy in a way that will allow for early mobilization and rehabilitation while promoting fracture healing. Surgical treatment of the various types of hip fractures differs significantly. Dynamic Hip Screw (DHS) is one of treatment choice for intertrochanteric femoral fracture.
Point Of Interest
Seven case of intertrochantertic fracture was treated by DHS in Sanglah General Hospital from January until August 2015. Patient was followed up for functional outcome after surgery using Harris Hip Score.
Discussion
Harris Hip Score for all elderly patient that underwent ORIF DHS following Intertrochanteric Femoral fracture was good (total range of point 70-79). In terms of functional outcomes, same study found that 70% of patients treated with a compression hip screw required ambulatory aid 6 months after surgery, compared to only 38% pre-injury. Similarly, Medoff and Maes found only 50% of patients to be walking independently at the time of hospital discharge following compression hip screw treatment.
Conclusion
Surgical fixation of an intertrochanteric fracture is not different from any other geriatric hip fracture –the surgeon must consider not only fracture pattern but also the patient’s age, medical condition, and pre-injury functional status. Dynamic Hip Screw is one choice of surgical treatment of intertrochanter femoral neck in elderly that give good result of functional outcome after surgery.
