Disser Dissertation tion

171 Pages·2014·4.37 MB·English

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AKNOWLEDGEMENT
At the outset, I submit with immense devotion and sincere thanks to
Prof. Sharad M. Antin, , Professor, Department of Orthopaedics, S.N.
M.S.(Ortho)
Medical College for his inspiration, able guidance, timely advice and constant
support. His direct supervision and constant encouragement went a long way
in moulding this study.
I express my humble gratitude and thanks to my beloved teacher and co-
guide, Dr. Siddanna M. Patted, , Professor, for his guidance and able
M.S.(Ortho)
supervision. My most sincere thanks are due to Associate Prof. M. B.
Mulimani, , who has been an endless source of inspiration and for his
M.S (Ortho)
help throughout my postgraduate course.
I extend my deep sense of gratitude and respects to our beloved
Assistant Prof. Girish Vasanad, , for his suggestions to improve this
M.S(Ortho)
study.
I also express my humble gratitude to my teachers Assistant
Prof. Girish Naikwadi and Assistant Prof. Nagesh Sanakal, for their
M.S (Ortho)
able advice and support.
My most sincere thanks to my most beloved teachers Dr. Raju
Akkimaradi, Dr. Shyam Bhairi and Dr. Naveen Birader for moulding this
work and their untiring advice all throughout my post graduate course.
I express my deep sense of gratitude to Dr. Shushrut B, Dr. S. S.
Malipatil, Dr. Prasad for helping me throughout my postgraduate course.
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My heart-felt thanks to Dr. Kulkarni and Dr.Kotbagi and Department of
Physiotherapy for their moral support and guidance.
My sincere thanks to Prof. Prakashappa, Professor and Head of
Department of Anaesthesiology, Prof. Hulkund, Dr. Ramesh, Dr. Adarsh,
Dr. Uday, Dr. Chaya and other staff and post graduates from department of
Anaesthesia for their support towards the study.
I am very much indebted to Dr.Goura, Professor and Head of
Department of Radiology and their staff.
My heart-felt thanks to Prof. Ashok S. Mallapur, Principal, S.N.
Medical College, Bagalkot and Prof. Chandrashekar, Dean, H.S.K Hospital,
Bagalkot for permitting me to conduct the study. I express my thanks to all the
patients and their relatives who were a part of the study.
My affectionate thankful arms to all my co-postgraduates here from
Department of Orthopaedics, Dr. Ramakanth D, Dr. Nagendra Patel,
Dr. Prasad, Dr. Pratap, Dr. Nitesh for their constant help and advice for this
study.
I express my gratitude to my family and friends for their support.
I am thankful to Miss.Veena and Mr. Deepak of Sai DTP and Xerox,
Belgaum, for formatting, printing and binding of my dissertation.
Date: Dr. TAKKALLAPALLY HARSHA
Place:
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LIST OF ABBREVIATIONS
AAOS American Academy of Orthopaedic Surgery
⇒
AO Association of Osteosynthesis /
⇒
Arbeitsgemeinschaft Osteosynthesefragen
AP Antero-posterior
⇒
Cm Centimetre
⇒
COPD Chronic obstructive pulmonary disease
⇒
DHS Dynamic hip screw
⇒
DM Diabetes mellitus
⇒
HHS Harris Hip Score
⇒
HTN Hypertension
⇒
K wire Kirschner wire
⇒
PMDO Primary medial displacement osteotomy
⇒
SD Standard deviation
⇒
TAD Tip apex distance
⇒
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ABSTRACT
BACKGROUND & OBJECTIVES: Fractures of proximal femur are amongst the
most often encountered fractures by orthopedic surgeon. Many treatment techniques
are described in literature but internal fixation with Dynamic Hip Screw is the
treatment of choice. This study analyzes the outcome of treatment of intertrochanteric
fracture with Dynamic Hip Screw.
METHODS: Between December 2012 and June 2013, 45 patients with
intertrochanteric fracture who got admitted in H.S.K Hospital and research centre, S.
N Medical College, Bagalkot in the department of Orthopedics were subjected to
internal fixation with Dynamic Hip Screw and the results were evaluated
RESULTS: Average age incidence in the present study was 69.91 years. Male female
ratio was almost equal 51:49.All the fractures occurred after a fall. Evans stable
fractures were more common. Out of the 41 cases functional outcome evaluated using
Harris Hip Sore scoring at their last follow-up:18 cases (44%) had excellent, 11 cases
(27%) good, 12 cases (29%) fair.
INTERPRETATION & CONCLUSION: Internal fixation with Dynamic Hip
Screw is the treatment of choice for treatment of intertrochanteric fractures.
KEYWORDS: Dynamic Hip Screw, Tip Apex Distance, Intertrochanteric fracture,
Harris hip Score.
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TABLE OF CONTENTS
Serial CONTENTS Page No.
No.
1 INTRODUCTION 1
2 AIMS AND OBJECTIVES 3
3 REVIEW OF LITERATURE 5
4 MATERIALS AND METHODS 103
5 RESULTS 115
6 DISCUSSION 130
7 CONCLUSION 134
8 SUMMARY 135
9 BIBLIOGRAPHY 136
10 ANNEXURES
ANNEXURE –I -PROFORMA 147
ANNEXURE –II - CONSENT FORM 151
ANNEXURE – III –MASTER CHART 153
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