Reoperation of the DHS failure – retrospective analysis and our experience

Česká verzia

Authors: Maroš Hrubina ^1,2; Miroslav Skoták ¹; Zdeněk Rybář ml. ¹; Pavel Míka ¹
Authors place of work: Department of Orthopaedics, Hospital Pelhrimov ¹; Ortopedické oddělení Nemocnice Pelhřimov ¹; Faculty of Biomedical Engineering, Department of Medicine and Humanities Kladno, Czech Technical University in Prague ²; Fakulta biomedicínského inženýrství - katedra lékařských a humanitných oborů Kladno, ČVUT v Praze ²
Published in the journal: Úraz chir. 19., 2011, č.4

Summary

The aim of the study:
To present the results of proximal femoral fracutres treated by DHS aiming to failed and reoperated osteosyntheses.

Material and methods:
Between 1997 and 2008, 404 osteosyntheses DHS were performed as treatment of proximal femoral fractures in 377 patients averagely 82,2 years old aged (21-101). Twenty seven patients were operated for fracture of both sides. Osteosynthesis was always performed by 135° dynamic hip screw (Medin, Czech Republic). Fifteen times for femoral neck fracture, 389-times for trochanteric fracture. The group of patients was evaluated in the end of 2010 aiming at incidence and technique of failed DHS reoperations. X-ray examination of the femur was performed before patient´s discharge, in 6^thweek after operation and then in 3^rd, 6^th and 12^th month after the operation.

Results:
Seventeen failed and reoperated DHS (4,2 %) within 16 patients were reported. During the operation we performed: once – only the metal extraction, once - metal extraction with using of bone cement spacer, twice reoperation with 6-hole plate, twice reoperation with PFN, three times reoperation using cervicocapital endoprosthesis and eight times was reoperation performed by conversion to total hip arthroplasty. Due to infection two, out of 404 cases (0,5 %), DHS were reoperated. Out of 15 ostesyntheses of femoral neck fractures 3 (20 %) were reoperated. Out of 389 DHS applied to trochanteric fractures 14 (3,6 %) were reoperated. Mortality rate up to one year after the primary operation was 48%, up to one year after the reoperation was 19 %.

Conclusion:
Authors consider DHS method proper to treat stable pertrochanteric fractures and femoral neck fractures of younger patients. Reoperation (except femoral neck fractures) are rare, partialy they are the result of technical mistake during primary osteosynthesis.

Key words:
hip fracture, dynamic hip screw, failure rate, reoperation.

Zdroje

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Štítky

Surgery Traumatology Trauma surgery

Článek Liver injury in children

Článek Treatment of posterolateral corner injuries with anatomical reconstruction and/or high tibial osteotomy

Článok vyšiel v časopise

Trauma Surgery

2011 Číslo 4

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