Treatment of comminuted subtrochanteric fractures by dynamic hip screw.

Twenty four cases of fracture of the proximal femoral shaft treated with dynamic hip screw fixation are included. All had severe comminution with subtrochanteric extensions. Dynamic hip screw provided stable osteosynthesis and helped to achieve bone union within 18 weeks in 19 of 21 followed-up cases. The anatomical configuration of the femur was maintained with minimal limb length discrepancy in one case and knee flexion of more than 110 degrees in all. Weight bearing was achieved after a mean period of 7.5 weeks post-fixation. Complications of treatment are also presented. Different implants are used to treat this injury with variable results. Dynamic hip screw system is a satisfactory implant for internal fixation in patients with these difficult fractures.