Risk factors affecting the outcome of management of trochanteric fractures with sliding hip screw in elderly : A Retrospective and Prospective Observational study

Abhishek, Mannem (2016) Risk factors affecting the outcome of management of trochanteric fractures with sliding hip screw in elderly : A Retrospective and Prospective Observational study. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.

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Abstract

BACKGROUND: [ Intertrochanteric fractures are seen with increasing number and severity as the life expectancy of our population is increasing. The primary goal in the treatment of these Intertrochanteric fracture is to return the patient to his / her pre - fracture activity as early as possible. Early mobilization of these patients reduces the morbidity and mortality rate.For all these reasons, the treatment of intertrochanteric fracture by closed or open reduction and internal fixation has become the gold standard method of treatment.In this study we have analyzed the risk factors that affect the outcome of intertrochanteric fractures treated by Sliding hip screw fixation. MATERIALS AND METHODS: This study is based on both retrospective and prospective collection of data of patients who were admitted with intertrochanteric fractures in PSG Hospitals from from January 2011 to December 2013 and between May 2014 to Aug 2015 treated with sliding hip screw. All the risk factors were assessed pre-operatively and postoperatively and records were maintained. Data was analyzed using SPSS version 12. Chi-square was used. p value of <0.05 was considered to be significant. RESULTS: Out of total 78 patients 43 had union witout collapse, 27 had union with collapse and 8 had fracture failure.P value was found to be significant in Displacement, Inadequate lateral wall thickness, reverse obliquity and reduction.In this study we observed that combination of multiple risk factors has showed maximum failures than occurring in single. We also designed a outcome assessment score based on fracture factors.A mean score of 3.93 was seen in patients who had union with no collapse, 5.19 in patients who union with collapse and 6.62 in patients who had fracture failure. CONCLUSION: Trochanteric severity score is a useful tool to assess the outcome of management of intertrochanteric fractures. Sliding hip screw is still a good implant for majority of intertrochanteric fractures. When treated by sliding hip screw, Trochanteric fractures with inadequate lateral wall thickness has showed a very high failure rate.(63%)Reverse oblique type of trochanter fractures had a high failure rates.(50%) Displaced comminuted fractures had a failure rate of 13%.Above factors when it occurred in combination the failure rates significantly increased. Sliding hip screw may not be an ideal implant for thesekind of fractures.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Intertrochanteric fractures ; Risk factors ; Trochanteric severity score ; Sliding hip screw.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 21 Sep 2017 03:41
Last Modified: 21 Sep 2017 03:41
URI: http://repository-tnmgrmu.ac.in/id/eprint/3230

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