Outcome of Intertrochanteric Fractures in Elderly Patients treated with Dynamic Hip Screw.


  • Kamran Asghar Assistant Professor Department of Orthopaedics Fauji Foundation Hospital Rawalpindi
  • Raja Adnan Ashraf Department of Orthopaedics, Fauji Foundation Hospital Rawalpindi
  • Hamza Fareed Assistant Professor Department of Orthopaedics Fauji Foundation Hospital Rawalpindi
  • Noman Maqbool Professor Department of Orthopaedics, Fauji Foundation Hospital Rawalpindi
  • Mohammad Salim Professor/Head Department of Orthopaedics Fauji Foundation Hospital Rawalpindi


Dynamic Hip Screw, Harris Hip Score, Intertrochanteric.


Objective: To determine the functional outcome of intertrochanteric fractures in elderly patients treated with Dynamic Hip Screw(DHS).

Methods: This descriptive study was conducted in Orthopaedic Unit Pakistan Railway General Hospital Rawalpindi from 16th February 2016 and 16th February 2021.All elderly patients with stable intertrochanteric fractures(Evans type IA and Type IB) fulfilling the inclusion criteria were treated with DHS and functional outcome was evaluated at 6 months with Harris Hip Score(HHS) and results were graded as excellent(HHS score 90 to 100),good(HHS score 80 to 90), fair(HHS 70 to 80) and poor(HHS score <70).

Results: We operated 280 patients of intertrochanteric fractures with DHS. The mean age was 65.49±7 years. Male patients were 170(60.71%) and female 110(39.28%). Excellent outcome was documented in 151(53.92%), good in 90(32.14%),fair in 22(7.85%) and poor in 17(6.07%) with HHS score of 93.3±5,88.7±7, 77.3±4 and 33.1±9 respectively.

Conclusion: Elderly patients with stable intertrochanteric fractures treated with Dynamic Hip Screw(DHS) yielded excellent and good functional outcome in majority of our patients. We recommend DHS an implant of choice to treat stable intertrochanteric fractures in elderly patients.


Sozen T, Oz???k L, Ba?aran NÇ. An overview and management of osteoporosis. Eur J Rheumatol. 2017;4(1):46-56.

Tsuda T. Epidemiology of fragility fractures and fall prevention in the elderly: a systematic review of the literature. Curr Orthop Pract. 2017;28(6):580-585.

Hu ZS, Liu XL, Zhang YZ. Comparison of Proximal Femoral Geometry and Risk Factors between Femoral Neck Fractures and Femoral Intertrochanteric Fractures in an Elderly Chinese Population. Chin Med J (Engl). 2018;131(21):2524-2530.

Lu Y, Uppal HS. Hip Fractures: Relevant Anatomy, Classification, and Biomechanics of Fracture and Fixation. Geriatr Orthop Surg Rehabil. 2019;10:215-220.

Jang JM, Choi HS, Lee JS, Jeong KY, Hong HP, Ko SH. Femoral Intertrochanteric Fractures of the Patients in the Emergency Department due to Minor Falls: Special Consideration in the Middle-old to Oldest-old Patients. Ann Geriatr Med Res. 2019;23(3):125-132.

Leu TH, Chang WC, Lin JC, Lo C, Liang WM, Chang YJ, Shih DP, Wu CC, Cheng CF, Wei SJ. Incidence and excess mortality of hip fracture in young adults: a nationwide population-based cohort study. BMC Musculoskelet Disord. 2016;17:326-330.

Ju JB, Zhang PX, Jiang BG. Risk Factors for Functional Outcomes of the Elderly with Intertrochanteric Fracture: A Retrospective Cohort Study. Orthop Surg. 2019;11(4):643-652.

Boissonneault A, Mener A, Schwartz A, Wilson J, Staley C, Schenker M. Impact of Frailty on 30-Day Morbidity and Mortality of Patients With Intertrochanteric Femur Fractures. Orthopedics. 2019;42(6):344-348.

Ibrahim S, Meleppuram JJ. A retrospective analysis of surgically-treated complex proximal femur fractures with proximal femoral locking compression plate. Rev Bras Ortop. 2017;52(6):644-650.

Sharma A, Sethi A, Sharma S. Treatment of stable intertrochanteric fractures of the femur with proximal femoral nail versus dynamic hip screw: a comparative study. Rev Bras Ortop. 2017;53(4):477-481.

van de Ree CLP, De Jongh MAC, Peeters CMM, de Munter L, Roukema JA, Gosens T. Hip Fractures in Elderly People: Surgery or No Surgery? A Systematic Review and Meta-Analysis. Geriatr Orthop Surg Rehabil. 2017;8(3):173-180.

Mardani-Kivi M, Mirbolook A, Khajeh Jahromi S, Rouhi Rad M. Fixation of Intertrochanteric Fractures: Dynamic Hip Screw versus Locking Compression Plate. Trauma Mon. 2013;18(2):67-70.

Lorich DG, Geller DS, Nielson JH. Osteoporotic pertrochanteric hip fractures: management and current controversies. Instructional Course Lectures. 2004 ;53:441-454.

Evans EM. The treatment of trochanteric fractures of the femur. J Bone Joint Surg Br 1949;31B:190-203.

Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51(4):737-755.

Alam W, Jan R, Khan MI, Rehman SU, Shah FA, Ahmad S. Our experience of dynamic hip screw fixation for intertrochanteric fracture of femur Pak J Surg. 2015;31(3):200-203.

Khalid M, Hashmi I, Rafi MS.The outcome of dynamic hip screw fixation in intertrochanteric femur fractures.Pak J Surg.2015;31(1):40-4.

Baig N, Sahito B, Ahmed N, Mehboob G.Functional out come of dynamic hip screw fixation in intertrochanteric fracture.J Pak Orthop Assoc. 2014;26(2):31-35.

Khan NU, Askar Z, Ahmed I, Durrani Z, Khan MA, Hakeem A, et al. Intertrochanteric fracture of femur. Professional Med J. 2010;17(2):328-33.

Pirwani M, Memon A, Memon SA.Evaluation of stable and unstable intertrochanteric fracture of femur fixed with dynamic hip screw (DHS).Professional Med J.2016;23(01):76-80.

Saarenpaa I, Heikkinen T, Ristiniemi J, Hyvonen P, Leppilahti J, Jalovaara P. Functional comparison of the dynamic hip screw and the Gamma locking nail in trochanteric hip fractures: a matched-pair study of 268 patients. International Orthopaedics.2009;33:255–260.

Lee YS, Huang HL, Lo TY, Huang CR. Dynamic hip screw in the treatment of intertrochanteric fractures: a comparison of two fixation methods. International Orthopaedics.2007;31:683–688.

Wang CC, Lee CH, Chin NC, Chen KH, Pan CC, Su KC. Biomechanical analysis of the treatment of intertrochanteric hip fracture with different lengths of dynamic hip screw side plates. Technol Health Care. 2020;28(6):593-602.

Kim CH, Chang JS, Kim JW. Clinical outcomes of dynamic hip screw fixation of intertrochanteric fractures: comparison with additional anti-rotation screw use. Eur J Orthop Surg Traumatol. 2019;29(5):1017-1023.




How to Cite

Kamran Asghar, Raja Adnan Ashraf, Hamza Fareed, Noman Maqbool, & Mohammad Salim. (2022). Outcome of Intertrochanteric Fractures in Elderly Patients treated with Dynamic Hip Screw. Journal of Pakistan Orthopaedic Association, 34(01), 12–15. Retrieved from http://jpoa.org.pk/index.php/upload/article/view/615