Investigating the Relationship between the Proportion of Diameter of Femoral Neck to Diameter of Body of Nail in Prognosis of the Intertrochantric Fractures Treatment with Dynamic Hip Screw Method

Intertrochantric fracture treatment is one of the orthopedic problems in the elderly. Especially in unstable fractures and patients with osteoporosis the outcome of treatment is not satisfactory. This study introduces criterion which might be effective in the prognosis of the treatment. Between 2002-2007, 128 patients with unstable intertrochantric fracture who had a severe osteoporosis in terms of sigh’s criterion (grade 1-3) and were treated with DHS and had a Tip Apex Distance (TAD) below 25mm were followed up. In this patient Y/B (diameter of femoral neck/diameter of body of nail) and X/A (great diameter of femoral head/ diameter of pitch of nail) were calculated and failure of treatment was evaluated in different groups. The total amount of treatment failure was 33 (26%). the average age of patients was 74.4 years old. 86 patients were female and 42 of them were male. The greatest failure rate was seen in B1 group (21 cases) with Y/B≥3.6mm and in B2 group (23 cases) with X/A≥3mm. The mean of Y/B and X/A were 3.64 and 3.08 millimeters, respectively. Noting the high incidence of treatment failure especially in B1 and B2 groups which shows great incidence of the treatment failure in patients with large femoral neck and head diameter, new treatment measures should be taken to improve the treatment prognosis of unstable intertrochantric fractures especially in patients with large femoral neck and head diameter.