COMPARISON BETWEEN FUNCTIONAL OUTCOME OF PATIENTS OF DYNAMIC HIP SCREW (DHS) AND BIPOLAR HEMIARTHROPLASTY IN INTERTROCHANTERIC (I/T) FRACTURE OF OSTEOPOROTIC BONES

Abstract

OBJECTIVE

To compare the functional outcome of patients of the dynamic hip screw (DHS) and bipolar hemi arthroplasty in unstable intertrochanteric (I/T) fracture of osteoporotic bones.

METHODOLOGY

This randomized controlled trial was conducted at the department of orthopaedics, Dr. Ruth K.M. Pfau Civil hospital, Karachi, and targeted patients aged 50-80 years with unstable intertrochanteric fractures as a result of osteoporosis. The total sample of 169 patients were randomly chosen to be either subjected to Dynamic Hip Screw fixation or Bipolar Hemiarthroplasty. The Modified Harris Hip Score was used to measure functional recovery six months post-surgery. Data analysis was done with the help of SPSS version 26, descriptive statistics were used, and Chi-square tests. The p-value below 0.05 was the statistically significant value.

RESULTS

The study involved 338 patients with 169 participants being in each group. The DHS group had a mean age of 64.12 ± 8.72 years whereas BHA had a mean age of 68.10 ± 7.91. The proportion of men in DHS group and BHA group was 62.1% and 51.5% respectively. Functional outcomes were better in the BHA group with significantly higher average of Modified Harris Hip Score of 85.99pm 8.02 than the DHS group with an average of 77.32pm 16.73 (p = 0.0001).

CONCLUSION

The results of this study demonstrate that bipolar hemiarthroplasty has better functional outcome than the dynamic hip screw fixation in elderly patients with osteoporotic unstable intertrochanteric fractures. Hemiarthroplasty patients had better Modified Harris Hip Scores and no adverse outcomes indicating it is more capable of delivering superior mechanical stability and early mobility and producing a less problematic and quicker rise to functional autonomy.