Valgus Osteotomy with DHS Fixation in the Management of Malunited Intertrochanteric Fractures in a Rural Population

INTRODUCTION: Malunited intertrochanteric fractures are frequently seen in rural populations as they tend to go in for native treatment with traditional bone setters. The resulting Coxa vara is associated with shortening, abductor weakness, limp and decreased range of movement of the affected hip. T...

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Main Author: Subash Y
Format: Article
Language:English
Published: Malaysian Orthopaedic Association 2020-11-01
Series:Malaysian Orthopaedic Journal
Subjects:
Online Access:https://www.morthoj.org/2020/v14n3/intertrochanteric-fractures.pdf
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author Subash Y
author_facet Subash Y
author_sort Subash Y
collection DOAJ
description INTRODUCTION: Malunited intertrochanteric fractures are frequently seen in rural populations as they tend to go in for native treatment with traditional bone setters. The resulting Coxa vara is associated with shortening, abductor weakness, limp and decreased range of movement of the affected hip. The aim of this study was to evaluate the role of Valgus osteotomy with Dynamic hip screw (DHS) fixation in the management of these fractures and to evaluate the functional outcome using the Harris hip score. MATERIALS AND METHODS: Fifteen patients with malunited intertrochanteric fractures who presented between January 2011 to January 2013 were managed by Valgus osteotomy with DHS fixation and were followed-up for a minimum period of three years. RESULTS: There was a male preponderance seen in our study with the right hip being more commonly affected. The most common mode of injury was slip and fall followed by road traffic accidents. The duration of native treatment ranged from seven to 12 weeks and the time of presentation to the hospital ranged from four to nine months following injury. Pre-operative mean neck shaft angle was 94.73° while it was 134.6° post-operatively. The mean pre-operative Harris hip score was 72.33 and it was 91 at follow-up. All patients were happy with the procedure and the functional outcome. CONCLUSION: Valgus osteotomy with DHS fixation is an effective procedure in the management of malunited intertrochanteric fractures. It corrects the limb length discrepancy, restores the decreased neck shaft angle, improves range of movement, restores the integrity of the abductor mechanism of the hip and gives good functional results.
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spelling doaj.art-65583684c5d1453987b7ba7424a63b1e2022-12-21T18:46:54ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2020-11-011439810310.5704/MOJ.2011.015Valgus Osteotomy with DHS Fixation in the Management of Malunited Intertrochanteric Fractures in a Rural PopulationSubash Y0DNBINTRODUCTION: Malunited intertrochanteric fractures are frequently seen in rural populations as they tend to go in for native treatment with traditional bone setters. The resulting Coxa vara is associated with shortening, abductor weakness, limp and decreased range of movement of the affected hip. The aim of this study was to evaluate the role of Valgus osteotomy with Dynamic hip screw (DHS) fixation in the management of these fractures and to evaluate the functional outcome using the Harris hip score. MATERIALS AND METHODS: Fifteen patients with malunited intertrochanteric fractures who presented between January 2011 to January 2013 were managed by Valgus osteotomy with DHS fixation and were followed-up for a minimum period of three years. RESULTS: There was a male preponderance seen in our study with the right hip being more commonly affected. The most common mode of injury was slip and fall followed by road traffic accidents. The duration of native treatment ranged from seven to 12 weeks and the time of presentation to the hospital ranged from four to nine months following injury. Pre-operative mean neck shaft angle was 94.73° while it was 134.6° post-operatively. The mean pre-operative Harris hip score was 72.33 and it was 91 at follow-up. All patients were happy with the procedure and the functional outcome. CONCLUSION: Valgus osteotomy with DHS fixation is an effective procedure in the management of malunited intertrochanteric fractures. It corrects the limb length discrepancy, restores the decreased neck shaft angle, improves range of movement, restores the integrity of the abductor mechanism of the hip and gives good functional results.https://www.morthoj.org/2020/v14n3/intertrochanteric-fractures.pdfintertrochanteric fracturesmalunionvalgus osteotomydhs
spellingShingle Subash Y
Valgus Osteotomy with DHS Fixation in the Management of Malunited Intertrochanteric Fractures in a Rural Population
Malaysian Orthopaedic Journal
intertrochanteric fractures
malunion
valgus osteotomy
dhs
title Valgus Osteotomy with DHS Fixation in the Management of Malunited Intertrochanteric Fractures in a Rural Population
title_full Valgus Osteotomy with DHS Fixation in the Management of Malunited Intertrochanteric Fractures in a Rural Population
title_fullStr Valgus Osteotomy with DHS Fixation in the Management of Malunited Intertrochanteric Fractures in a Rural Population
title_full_unstemmed Valgus Osteotomy with DHS Fixation in the Management of Malunited Intertrochanteric Fractures in a Rural Population
title_short Valgus Osteotomy with DHS Fixation in the Management of Malunited Intertrochanteric Fractures in a Rural Population
title_sort valgus osteotomy with dhs fixation in the management of malunited intertrochanteric fractures in a rural population
topic intertrochanteric fractures
malunion
valgus osteotomy
dhs
url https://www.morthoj.org/2020/v14n3/intertrochanteric-fractures.pdf
work_keys_str_mv AT subashy valgusosteotomywithdhsfixationinthemanagementofmalunitedintertrochantericfracturesinaruralpopulation