Biomechanical Evaluation of the Dynamic Hip Screw With Two- and Four-Hole Side Plates

McLoughlin, S. W.; Wheeler, Donna L.; Rider, Jill; Bolhofner, Brett R.

doi:10.1097/00005131-200006000-00002

Cited by 77 publications

(52 citation statements)

References 13 publications

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“…The type of DHS device used in both the minimally invasive surgical and conventional approaches were mainly four-hole side plates, but the choice of the length of the side plate was left to the individual surgeons. Biomechanical studies demonstrated equivalent peak load to failure results when comparing the two-and four-hole DHS plates [15]. In recent studies [13,22], stable pertrochanteric fractures (AO classification 31-A1 and 31-A2) had successful fixation with two-hole DHS.…”

Section: Discussionmentioning

confidence: 93%

Minimally invasive dynamic hip screw for fixation of hip fractures

Garau

Walley

et al. 2008

International Orthopaedics (SICOT)

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We compared a minimally invasive surgical technique to the conventional (open approach) surgical technique used in fixation of hip fractures with the dynamic hip screw (DHS) device. Using a case-control design (44 cases and 44 controls), we tested the null hypothesis that there is no difference between the two techniques in the following outcome measures: duration of surgery, time to mobilisation and weight bearing postoperatively, length of hospital stay, mean difference of pre-and postoperative haemoglobin levels, position of the lag screw of the DHS device in the femoral head, and the tip-apex distance. The minimally invasive DHS technique had significantly shorter duration of surgery and length of hospital stay. There was also less blood loss in the minimally invasive DHS technique. The minimally invasive DHS technique produces better outcome measures in the operating time, length of hospital stay, and blood loss compared to the conventional approach while maintaining equal fixation stability.Résumé Ce travail a pour but de comparer les techniques de fixation de fractures de la hanche par voie mini-invasive ou par voie d'abord conventionnelle avec utilisation de matériel de type DHS. Nous avons pour cette étude regroupé les patients en deux groupes, 44 cas par voie mini-invasive et 44 cas contrôle. Nous avons voulu tester l'hypothèse suivante: existe-t-il une différence entre ces deux techniques, sur la durée d'intervention, de reprise de l'appui post-opératoire; de durée moyenne de séjour des pertes sanguines notamment et enfin, en ce qui concerne la position de la vis céphalique dans la tête fémorale et sa distance par rapport à l'interligne. La technique mini-invasive entraîne de façon significative un temps chirurgical diminué et une diminution de la durée moyenne de séjour. Ceci est également vrai pour les pertes sanguines. Cette technique est pour nous supérieure en ce qui concerne ces items si on la compare à l'abord de type conventionnel en sachant que les problèmes de stabilité du matériel sont identiques quelle que soit la technique utilisée.

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Section: Discussionmentioning

confidence: 93%

Minimally invasive dynamic hip screw for fixation of hip fractures

Garau

Walley

et al. 2008

International Orthopaedics (SICOT)

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“…[9][10][11] As a matter of surgeon's choice we did not use a shorter plate in any case to be confident regarding postoperative mobilization of the patient. Also many of our patients had Singh's index type 3 and 2 osteoporosis in whom fixation with a two hole plate was deemed to be risky in terms of stability.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive dynamic hip screw for intertrochanteric fractures: comparison with conventional method and surgical tips

Vidyarthi¹,

Paluvadi

Sinha

2017

Int J Res Orthop

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Background: Intertrochantric fractures of the proximal femur are one of the most common injuries of the elderly. Prolonged duration and peroperative blood loss in this elderly frail population is one of the major problems in using the DHS. We performed minimally invasive DHS (MIDHS) implantation for such patients and compared results with conventional technique, hypothesising better perioperative outcomes.Methods: We operated upon 30 cases as the case group from June 2013 to August 2016 with this technique. Patients older than 60 years of age with BMI less than 25 with stable AO type fractures which were easily reducible without sag of the distal fragment were included. In a control group 30 patients who had their hip fracture fixed with a DHS placed through the conventional approach were included. These groups were matched for sex, age, ASA grade and fracture type according to the AO classification. All surgeries were performed within 3 weeks of injury. We studied the patients in terms of time taken for surgery, peroperative blood loss, postoperative pain scores, need for analgesics and improvement in postoperative mobilization and rehabilitation by HHS.Results: Blood loss, duration of surgery and average pain score were significantly lower (p <0.0001) for MIDHS group due to a smaller incision and less muscle dissection. The HHS was also significantly better at 10 days in the MIDHS group. Conclusions: Minimally invasive DHS is a simple and effective technique for fixation of intertrochantric fractures, especially in elderly, with reduced operative time, blood loss and postoperative pain scores leading to a more effective postoperative rehabilitation.

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“…This finding is also consistent with the results of published biomechanical and clinical studies. [4][5][6][7][8][11][12] The previously reported clinical series, however, either compared the plates in the management of stable fractures specifically or had small samples of un stable fractures.…”

Section: Discussionmentioning

confidence: 99%