创伤与治疗杂志

Pertrochanterial Fractures: Complications and Results of Osteosynthesis by Dynamic Hip Screw(DHS) Vis-Plate without Fluoroscopy in Niger

Abstract

Abdoul Wahab Allassane Mohamed, Ide Garba, Badarou Chaibou, Mahamadou Dalatou Habibou and Souna Badis Seyni

Introduction: Pertrochanteric fractures are frequent fractures. They are the prerogative of the elderly, affecting the young man as a result of a high energy mechanism. The complications are sometimes formidable. Different treatments are possible. In some cases, DHS screwplate osteosynthesis easily reduces these pertrochanteric fractures. The main objective of this work was to study the infectious complications and consolidation defects of DHS screw-plate osteosynthesis of pertrochanteric fractures. The secondary objective was to assess functional results. Our hypothesis was that the complication rate was low.

Materials and methods: This was a retrospective single-center study including internal fixation by DHS screw-plate (March 2017 to May 2020) excluding patients with severe comorbidity.

Results: The series includes 36 internal fixation: 30 predominantly male (83.33%) and young (mean age: 39.1 years) patients, with an average follow-up of 18 months. thirty-four fractures were analyzed. We noted two cutaneous or infectious complications, one of which required revision surgery. One patient had to undergo revision surgery for early unraveling of the osteosynthesis material. The mean PMA score was 12.2: 4-18. Functional results were excellent in 34% and good in 31% of cases. The unstable fractures had a poor prognosis.

Discussion: We found a slightly lower complication rate than in the literature. Functional scores were slightly lower. Dysesthesia of the superior gluteal nerve is a relatively common complication. Two thromboembolic disorders. A high rate of complications and sometimes modest results encourage reflection on the surgical technique and its indication. Minimally invasive and fluoroscopic approaches remain the solution in all cases.

Conclusion: The management of pertrochanteric fractures must be an à la carte surgery, taking into account in our context the technical platform, the patient's condition, and the associated lesions, since the complications associated with open-site surgery without fluoroscopy is not negligible.