J Korean Hip Soc.  2009 Mar;21(1):29-34. 10.5371/jkhs.2009.21.1.29.

Treatment of Intertrochanteric Fractures in Patients with Severe Osteoporosis with Dynamic Compression Hip Screws

• Kim YS
• Kwon SY
• Lee YM
• Han SK

• KMID: 2190802
• DOI: http://doi.org/10.5371/jkhs.2009.21.1.29

Abstract

PURPOSE: The purpose of this study was to compare the clinical results in the treatment of femoral intertrochanteric fractures with dynamic compression hip screws (DHS) in patients with or without osteoporosis.
MATERIALS AND METHODS
Between March 2003 and February 2006, the clinical results in the treatment of intertrochanteric fractures of the femur with DHS in patients with severe osteoporosis (T score<-4.0 at the femoral neck by DXA; 56 patients [group 1]) and in non-osteoporotic patients (T score>-2.5; 46 patients [group 2]) were reviewed. We retrospectively compared the mortality rate, the incidence of postoperative complications or fixation failures, and the patterns between the two groups.
RESULTS
The mortality rate in group 1 was 30.4% at postoperative 1 year and 21.4% at 6 months. The mortality rate at 1 year was 21.8% in group 2 (p<0.05). There were no differences in fracture patterns according to the AO/OTA classification between the two groups. However, the incidence of fixation failures were 19.6% in group 1 vs. 13.0% in group 2 (p<0.05).
CONCLUSION
There was a higher postoperative mortality rate at 1 year (30.4% vs. 21.4%), and the incidence of fixation failures (19.6% vs. 13.0%) in the treatment of osteoporotic intertrochanteric fractures by DHS in osteoporotic compared to non-osteoporotic fractures.

Keyword

Femur; Intertrochanteric fracture; Dynamic compression hip screw; Osteoporosis

MeSH Terms

Femur
Femur Neck
Hip
Hip Fractures
Humans
Incidence
Osteoporosis
Postoperative Complications
Retrospective Studies