Comparative Study between Conventional Dynamic Hip Screw with Traditional Side Plate and Dynamic Hip Screw with Locked Side Plate in Intertrochanteric Fractures in Elderly Patients

Background: Being one of the most common geriatric fractures worldwide, intertrochanteric fracture represents approximately 50% of proximal femoral fractures. The aim of this study is to compare the one-year follow-up results of two groups of elderly patients with intertrochanteric fractures treated by traditional dynamic hip screw (DHS) versus DHS with locked plate. Methods: This randomized clinical trial was conducted on 40 geriatric osteoporotic patients with intertrochanteric fractures. The patients were randomly categorized into 2 equal groups; Group A was treated with conventional DHS plate and Group B was treated with locking DHS plate. The patients were evaluated by adequate history, clinical examination, and plain X-ray. Results: The duration of hospital stay was significantly shorter in group B compared to group A (P=0.015). The functional score was considerably higher in group B compared to group A (P=0.002). The time of union and time of weight bearing was significantly shorter in group B compared to group A (P<0.001, <0.001). Postoperative complications were reported only in group A, as infection occurred in 4 (20%) patients and cut-out occurred in 2 (10%) patients. No complications were reported in group B. Conclusions: Locking plate DHS is superior to conventional DHS in terms of mechanical stability and earlier rehabilitation and weight bearing, with lower failure rates.