TITLE:
Treatment of Trochanteric Mass Fractures by Dynamic Screw-Plate (DHS) in the Orthopedic-Traumatology Department of the Donka National Hospital: 25 Cases
AUTHORS:
Barry Alhassane, Diallo Mamadou Moustapha, Camara Nouhou Mangué, Diallo Alpha Mamadou Felah, Sidimé Sory, Diallo Ibrahima Gallé, Lamah Léopold
KEYWORDS:
Massive Trochanteric Fractures, Dynamic Plate Screw, Donka National Hospital
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.14 No.12,
December
6,
2024
ABSTRACT: Objective: To evaluate the radiological and functional results of patients treated with dynamic screw plates (DHS) for trochanteric fractures in the Orthopedics-Traumatology Department of the Donka National Hospital. Methodology: This was a five (05)-year continuous retrospective study from January 1, 2019, to December 31, 2023. We used the Watson-Jones pathway without an image intensifier. Patients were evaluated according to the Postel-Merle D’Aubigné evaluation criteria. Results: A total of 25 trochanteric fractures were recorded. The patients were 16 men and 9 women, with a sex ratio of 1.77 and an average age of 63.5 years, with extremes of 31 and 96 years. The average fracture management time was 4.04 days. Etiologies were dominated by road traffic accidents (52.00%), followed by domestic accidents (falls) (44.00%). Merchants and housewives were the most affected (32.00%). According to the Ender classification, type III fractures (n = 15; 60.00%) were the most common, followed by type VII (n = 4; 16.00%). The procedure was performed 23 times (92.00%) under spinal anesthesia, 2 times (8.00%) under general anesthesia. The average hospital stay was 9.6 days. The mean operative time was 105.6 min, with extremes ranging from 90 to 120 min. The mean time to consolidation was 14.88 weeks, with extremes of twelve and twenty weeks. Comorbidities included hypertension and diabetes. The majority of patients (76.00%) had good anterior autonomy according to the Parker index. The mean index was 8.2 [standard deviation ±1.8]. We noted three cases of post-operative death (12.00%). We evaluated nineteen patients with a mean follow-up of 24 months, and the functional results according to Postel and Merle d’Aubigné scores were excellent in 42.10% (n = 8), good in 52.63% (n = 10), and fair in 5.2% (n = 1). Conclusion: The DHS dynamic screw-plate has enabled us to achieve good radiological and functional results, enabling us to resume daily activities as quickly as possible. It appears to be a reliable solution for trochanteric fractures. It can be performed without an image intensifier, provided we are aware of its limitations.