[The dynamic hip screw for the management of per- and subtrochanteric femoral fractures].

A total of 125 patients with pertrochanteric or subtrochanteric fractures were treated by means of internal fixation with dynamic hip screws (DHS), and 77 were reviewed both clinically and radiologically after an average period of 29 months (6-69 months). This study included group A 2 fractures (with a large lesser trochanter fragment) and group A 3 fractures (pertrochanteric region) according to the ASIF classification, and also fractures of the proximal femoral shaft. With proper surgical technique only 5 cases of early infection (4%) were recorded. Early mobilization of these patients was possible owing to stable implants. There were 7 patients (5.6%) who died while still in hospital. Of the 77 patients in whom follow-up was possible, 76 had results falling in the very good or good categories according to the Merle d'Aubigné scheme. During this follow-up period 3 cases of implant fracture were encountered. In all other cases progression to bone union was uneventful. These results show that the use of DHS is a reliable method of stabilizing unstable pertrochanteric and subtrochanteric fractures.