Abstract:
Background: Fixation of Intertrochanteric Fractures with Dynamic Hip Screw allows compression of the fracture when patient starts weighing. Placement of lag screw should be central in head and neck of femur. This study aimed to emphasize the clinical value of the tip apex distance as a reliable predictor of cut-out of lag screw in fixation of stable fractures. Patients & Methods: This is a retrospective cohort study included 18 cases, skeletally mature patients with post traumatic intertrochanteric fractures treated with DHS in the period from January 2016 to December 2016 with follow up 6 months at least at Zagazig University Hospital. Intertrochanteric Fractures were internally fixated with DHS, and by follow up postoperatively, we measured TAD index post operatively and after 6 months by summation on x rays ,after correction had been made for magnification to detect the importance of TAD on stability of lag screw in the head and neck of femur and reported cases that developed cut through of lag screw. Results: TAD is the main measurement in the study .The rate of implant failure and cut through was (27.8%).the median of TAD postoperative was (2.05).the median of TAD after 6 months was (2.23).
Conclusions: TAD of less than 25mm is safe .If TAD is more than 25mm, it may result in penetration of implant, non-union, cut through and other complications. So TAD is a reliable factor and has a great value in DHS operations.