Use of Minimal Invasive Technique in Dynamic Hip Screw Fixation

Ponnusami Pillai Gokulakrishnan, Pranesh Kumare Manoharan, Annamalai Sakthivel

Abstract


Among different implants like Proximal Femoral Nailing, Dynamic Hip Screw, Proximal Femoral Locking Plate used in fixation of intertrochanteric fracture, minimally invasive Dynamic Hip Screw has several advantages. Surgeons treating patients with low economic resource with surgical co-morbidity could not routinely use less invasive imported implants due to high cost or poor quality of local intramedullary implants. Minimal Invasive Dynamic Hip Screw will be the possible solution. Minimal Invasive Dynamic Hip Screw has several advantages like short learning curve, 4 times shorter incision than conventional Dynamic Hip Screw, comparable outcome, less operative time, less post-operative wound care. We consider Minimal Invasive Dynamic Hip Screw as one of the cost effective technique in intertrochanteric fracture management. Patient with stable intertrochanteric fracture and with co-morbidity which limiting his/her operative time will be the ideal candidate for Minimal Invasive Dynamic Hip Screw.  Most of the surgeons think special instrument sets are necessary to perform Minimal Invasive Dynamic Hip Screw but the truth is instruments used for routine fracture fixation and conventional Dynamic Hip Screw instruments are more than sufficient for Minimal Invasive Dynamic Hip Screw. In our center we routinely perform Minimal Invasive Dynamic Hip for patients with low economic resource with surgical co-morbidity could not routinely use less invasive imported implants due to high cost or poor quality of local intramedullary implants. And all patients give encouraging results in regards with early mobilization and radiographic fracture union. None of our cases had potential complications like superior cut through, implant failure, and infection. In summary Minimal Invasive Dynamic Hip Screw. technique had comparable outcome with intramedullary and conventional Dynamic Hip Screw fixation in terms of operative time, blood loss, duration of hospital stay and fracture union rate. Hence we recommend Minimal Invasive Dynamic Hip Screw. fixation technique with low economic resource patient with co-morbidities restricting operative time.

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References


(1) Mahmood, A., M. Kalra, and M. K. Patralekh. "Comparison Between Conventional And Minimally Invasive Dynamic Hip Screws For Fixation Of Intertrochanteric Fractures Of The Femur". ISRN Orthopedics 2013 (2013): 1-6. Web. 27 Jan. 2017.

(2) Dayanand,M . Deepak S, Kumar.M, Kumar.V, Patil.M.S. "Management Of Intertrochanteric Fractures Of Femur By Minimally Invasive Dynamic Hip Screw". IOSR Journal of Dental and Medical Sciences 13.4 (2014): 68-72. Web.




DOI: http://dx.doi.org/10.15383/jmio.19

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