بررسی کاربرد Short barrel DHS در درمان شکستگی انترتروکانتریک

Cut out or extrusion of the lag screw from the superior aspect of head and neck of the femur is one of the most common and devastating complications of the surgery of the intertrochanteric fractures with DHS. The exact cause of this complications is unknown, but it seems to be related to osteopenia, inappropriate position of lag screw inside head of the femur and inability of DHS to slide inside the barrel, which is the most ignored risk factor. We used short barrel Dynamic Hip Screw (DHS) for fixation of the intertrochanteric fractures in Dimon and Hughston procedure in 16 patients with unstable fracture, from may to August 2000. The only patient suffered from cut out is the one with static position of DHS in the center of the head. The other complications were delayed ::::union:::: in one, disingagement of the lag screw and side plate despite using compression screw, and one case of significant limb length discrepancy 6 months after surgery, mild limbing was the rule and the average of harris scores was 76. We think that, it is possible to reduce the rate of cut out with choosing short barrel DHS instead of the standard one, while using short length lag screw.