Abstract

PINHEIRO, Luís Ferraz et al. Desmontagem de DHS nas fraturas transtrocantéricas do fémur: Fatores predisponentes. Rev. Port. Ortop. Traum. [online]. 2012, vol.20, n.1, pp.65-71. ISSN 1646-2122.

The treatment of choice for trochanteric fratures of the femur is the surgical treatment that allows early rehabilitation, offering a better chance of functional recovery. DHS (Dynamic Hip Screw) is the most widely used implant for stabilization of such fratures. Are described failure rates of osteosynthesis with DHS between 1.1% to 12.6%. The authors conducted a cross-sectional evaluation of patients in which there was failure of DHS, covering the period from January 1998 to December 2006. We analyzed the epidemiological characteristics of patients, the pattern of frature, the postoperative complications and surgeon's experience. There was also a post-operative radiological evaluation. Results were compared with those of a control group. It was found a failure rate of 8.61%. Patients had a mean age of 79 years. The failures occurred in unstable fratures (AO / ASIF 31-A2, 31-A3-31-B2). Screws centered or off-centered to inferior are associated with a higher success rate. The main reasons for failure of material seem to be the bad treatment decision, using DHS in unstable fratures, the failure to obtain an anatomical / stable reduction and poor placement of the screw, eccentric upper and / or anteriorly.

Keywords : Proximal femur frature; DHS; failure.

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