Ul Haq Farman, Sabir Kamran, Akbar Hazrat, Khan Ziarmal, Ullah Abid, Khan Rehmat
Department of Orthopaedics, Ghurki Trust Teaching Hospital, Lahore, PAK.
Department of Orthopaedics, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Cureus. 2025 May 17;17(5):e84277. doi: 10.7759/cureus.84277. eCollection 2025 May.
Objective The objective of this study was to determine the functional of valgus osteotomy with dynamic hip screw (DHS) fixation in managing patients diagnosed with varus malunion and non-union trochanteric fractures. Methodology This descriptive case series was conducted at the Department of Orthopaedics and Spine Centre, Ghurki Trust Teaching Hospital, Lahore, Pakistan, from June 7, 2023, to December 7, 2023. A total of 80 patients aged above 40 years with malunited or non-united trochanteric fractures were included using non-probability consecutive sampling. Patients with active hip infections or lost to follow-up were excluded. Ethical approval was obtained, and informed consent was taken. All patients underwent valgus osteotomy under spinal anesthesia, followed by fixation with a DHS. Postoperative follow-ups were conducted at two and three months, with functional outcomes assessed using the Harris Hip Score (HHS) at three months. Data were analyzed using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States), with p ≤ 0.05 considered statistically significant. Results The study included 80 patients with a mean age of 54.83 ± 10.41 years, predominantly male (85.0%). Falls were the most common mode of injury (n=48, 60.0%). The mean HHS at three months postoperatively was 84.74 ± 8.06, with 37.5% (n=30) of patients achieving excellent outcomes, 40.0% (n=32) good, 17.5% (n=14) fair, and 5% (n=4) poor. Stratification by gender, age, and mode of injury showed no statistically significant differences in outcomes (p > 0.05). Conclusion Valgus osteotomy with DHS fixation demonstrated good outcomes in the majority of participants, followed by excellent outcomes. While female and younger patients showed slightly better results, these differences were not statistically significant. Falls were the most common cause of injury, and the procedure achieved high success rates regardless of the mode of injury. These findings support valgus osteotomy with DHS fixation as a reliable treatment for nonunion and malunion trochanteric fractures.
目的 本研究的目的是确定采用动力髋螺钉（DHS）固定的外翻截骨术在治疗诊断为转子间骨折内翻畸形愈合和不愈合患者中的作用。方法 本描述性病例系列研究于2023年6月7日至2023年12月7日在巴基斯坦拉合尔古尔基信托教学医院骨科和脊柱中心进行。采用非概率连续抽样纳入80例年龄在40岁以上的转子间骨折畸形愈合或不愈合患者。排除有活动性髋部感染或失访的患者。获得了伦理批准并取得了知情同意。所有患者在脊髓麻醉下接受外翻截骨术，随后用DHS固定。术后在2个月和3个月进行随访，在3个月时使用Harris髋关节评分（HHS）评估功能结果。使用IBM SPSS Statistics for Windows，版本23（2015年发布；IBM公司，美国纽约州阿蒙克）进行数据分析，p≤0.05被认为具有统计学意义。结果 该研究纳入了80例患者，平均年龄为54.83±10.41岁，以男性为主（85.0%）。跌倒为最常见的受伤方式（n = 48，60.0%）。术后3个月时的平均HHS为84.74±8.06，37.5%（n = 30）的患者获得优秀结果，40.0%（n = 32）为良好，17.5%（n = 14）为中等，5%（n = 4）为差。按性别、年龄和受伤方式分层显示结果无统计学显著差异（p>0.05）。结论 采用DHS固定的外翻截骨术在大多数参与者中显示出良好的结果，其次是优秀的结果。虽然女性和年轻患者的结果略好，但这些差异无统计学意义。跌倒是最常见的受伤原因，但无论受伤方式如何，该手术均取得了较高的成功率。这些发现支持采用DHS固定的外翻截骨术作为转子间骨折不愈合和畸形愈合的可靠治疗方法。
