Comparison of the Results of Fixation of Reverse-Oblique Intertrochanteric and Short-Segment Subtrochanteric Fractures Using Dynamic Hip Screw (DHS) and Dynamic Condylar Screw (DCS)

In intertrochanteric fractures, dynamic hip screw (DHS) is the most frequently used tool, but several studies did not give good results for this device in reverse-oblique and transverse fractures. Current study aimed to compare fixation results of reverse-oblique intertrochanteric and short-segment subtrochanteric fractures using dynamic condylar screw (DCS) and DHS in patients referred to Alzahra and Kashani Hospitals in Isfahan, Iran.
In a cross-sectional study, medical files of the patients referred to emergency units of the two hospitals who were diagnosed with intertrochanteric or subtrochanteric fractures and underwent DHS or DCS surgery more than 6 months before were assessed; they were invited for follow-up visit and examination. Written consent forms were taken from all the patients upon their entry; and they were examined in terms of complications including nonunion and failure of device and level of fracture improvement. These cases were evaluated by simple radiography, too. Results obtained from examination of patients in addition to demographic information were recorded in the data collection form for each patient.
Findings: Perfect union was observed in 14 (of 25) patients in DHS group and 21 (of 25) patients in DCS group (56% vs. 84%) six months after the surgery. Bone union was significantly better in DCS group (P = 0.031). In addition, six months after the surgery, the devices used in 14 people in DHS group and 24 people in DCS group were fixed and the difference between the two groups was significant (P = 0.001). 14 and 24 patients had total recovery in DHS and DCS groups, respectively (20% vs. 44%) with a significant difference (P = 0.020).
Considering obtained results, it can be concluded that using DCS is recommended over DHS due to severity of pain, bone union and fixation of the device.