Complications of surgical treatment for femoral intertrochanteric fractures using dynamic hip screw

Objective:To investigate the complications of surgical treatments for femoral intertrochateric fractures using dynamic hip screw(DHS).Methods:From Jan.2002 to Dec.2007,sixty-nine patients with intertrochanteric fractures were treated by dynamic hip screw fixation included 27 males and 42 females,with an average age of 72.9 years ranging from 53 to 96 years.According to Evans classification there were 10 cases in typeⅠ,21 in typeⅡ,22 in type Ⅲ,and 16 in type Ⅳ,of which 51 patients(73.9%) suffered from systematic diseases preoperatively.Results:Fifty-seven patients were followed up for 8 to 70 months(41 months on average).Four patients died,17 cases occurrenced systematic complications postoperatively.Internal fixation related complications occurred in 12 patients.There were 8 cases with mechanical failure of DHS including 4 of screw loosen,3 of cutting-out of device through femoral head and neck and 1 of plate breakage.Five patients had a coxa vara,and delayed union occurred in 4 patients.Cnclusion:Unstable fracture pattern produced high percentage of mechanical faliure.In such cases DHS should not be the first choice for treatment.The appropriate treatment should be in relation to pre-operative fracture stability and osteoporosis.