Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Orthopedics Surgery

Objective: the aim of this study is to compare between dynamic hip screw with trochanteric stabilizing plate and short gamma nail in unstable trochanteric fractures regarding functional and radiological outcome. Introduction: Intertrochanteric femoral fractures are common in the elderly. They account for more than 50% of all hip fractures and are a common orthopedic problem in this age group (1).They are extra capsular fractures of the proximal femur between the greater and lesser trochanters. Due to the mortality and significant morbidity associated with these fractures, they constitute a major challenge to all orthopedic surgeons (2), (3). There are many classification systems for these fractures.The most classic one is Evans classification which divides them into stable and unstable fractures based on the fracture pattern (4). Management of stable trochanteric femoral fractures by dynamic hip screw (DHS) is proven to be the best option However, there is a high DHS failure rate with unstable trochanteric femoral fractures. Hence, various fixation devices have been introduced to replace DHS in unstable fractures.These include the add-on trochanteric stabilizing plates, fixed angle blade plates, proximal femoral locked plates and different designs of cephalomedullary nails (6). Patient and method:A total of 34 patients with unstable trochanteric fractures treated surgically between June 2019 and September 2019 were included into the study and followed up for at least 6 months. Study duration: from June 2019 to February 2020.Seventeen patients underwent fixation by short gamma nail and seventeen patients underwent fixation by DHS with TSP.The mean age in DHS with TSP was 64.69 while mean age in Gamma nail group was 69.17. In DHS with TSP group there was 11 male and 6 females while in Gamma nail group there was 10 males and 7 females

Issued also as CD