Abstract

Introduction: Hip fracture involves fracture of the femoral neck, intertrochanteric and subtrochanteric fractures. There have been controversies in the choice for the best fixation method for the various forms of hip fractures. Among the options, dynamic hip screw (DHS) offers fast and stable fixation with acceptable complication rates. The study aimed to share our experience with using DHS as a fixation method for adult hip fractures in our centre. Methods: This is a retrospective study of 121 adult patients who had DHS screw fixations for proximal femoral fractures from June 2015 to May 2018 at Orthopaedic Hospital Wamakko, Sokoto, North-western region of Nigeria. Results: There were 95 (79%) males and 26 (21%) females with a mean age of 51 years (range 18 to 95 years). Right-sided fracture occurred in 67 (55%) patients and the left-sided in 54 (45%) patients. Seventy-two patients (60%) had road traffic accident (RTA), 38(31%) patients had falls, nine (7%) had sports injuries, and 2 (2%) had assaults. Seventy-two (60%) patients sustained intertrochanteric fractures, 38 (31%) femoral neck fractures, and 11 (9%) subtrochanteric fractures. The longest duration of presentation and average waiting time before surgery were 3 to 4 weeks in 11(9%) patients and 5 days respectively. Forty- -three (35%) patients had open reduction and the longest surgery time was an average 2.1 hours. The average follow-up period was 2.6 years, and the subjective clinical outcomes at 6 months follow-up were 76(63%) excellent, 26 (21%) good, 11 (9%) fair, and 8 (7%) poor results. The mean Parker mobility score for the 114 patients was 6.1 before the injury and 4.3 at 1 year follow-up. Postoperative complications were 4 (3.3%) non-union, 3 (2.5%) screw cut-outs, 3 (2.5%) AVN, 3 (2.5%) Limb length discrepancy of greater than 2cm, 2 (1.7%) implant infections, 2 (1.7%) Coxa vara, and 2 (1.7%) hip osteoarthritis. Conclusion: The use of DHS fixation devices for hip fractures in adults generally has good outcomes when appropriately indicated in patients with early presentation

Keywords

dynamic hip screws, hip fractures, internal fixation, proximal femur fractures