on intertrochanteric fractures treated with the DHS device, the incidence of device failure was reported to be 16.7% ( 13) however our study found a lower rate (5%). The therapeutic results of intertrochanteric fractures fixation with LCP have not yet been fully determined. Even though fixation with the DHS device has been the gold standard treatment for stable intertrochanteric fractures ( 11, 12), there are many complications reported for unstable intertrochanteric fractures (3-26 %) ( 10). Nearly half of all hip fractures are intertrochanteric fractures. All data was analyzed by SPSS software (P < 0.05 was considered statistically significant). Analysis was performed by descriptive statistics, the Chi square test and independent t-test. A diminished measurement of more than 20 mm was considered as limb shortening, cutting out or breaking of the device was considered as device failure and serous or purulent discharge from the incision site was considered as evidence of an infection. During both the 6-month postoperative visit and the final visit (between 9 and 31 months after the surgery), patients were examined regarding certain variables such as the Harris Hip Score (to evaluate the function of hip joint) and existence of common complications, including limb shortening (in the following visits), device failure and infection. Demographic features such as age and gender, the existence or nonexistence of fracture stability (comminuted fractures owing displacement of lesser trochanter, with posterior medial defect and reverse oblique fractures are unstable fractures) ( 10) and operating time were obtained via questionnaire. All patients were evaluated for rotation of the femur with the patella in a horizontal position. Patients were discharged when they had partial weight bearing ability on the fracture. For approximately 48 hours, a drain was used. The location of the nail in the fixation using the DHS device and the screw in the fixation using the LCP device was determined by radiography. After general anesthesia and reduction under fluoroscopy, patients were prepared for the fracture fixation with a DHS or LCP device through a lateral approach. All patients underwent an operation by one orthopedic specialist (the first author of the paper). A total of 104 patients were included in this study and all patients’ information was considered highly confidential.To select the patients we took into account various factors such as the availability of the device, the economic situation of the patients and the environment of the operating room. Other patients, who were never available for follow-ups, due to death or other reasons, were also excluded. There were 54 patients who had polytraumatic or pathologic fractures patients with previous surgery in this same anatomical region and DJD in the hip joint were excluded. This cross-sectional study of patients with trochanteric fractures of the femur that were treated with either the DHS or LCP device at Pursina Hospital in Rasht, Iran from March 2009 until 2011 was conducted. The LCP is stated to be more suitable for stable and osteoporotic intertrochanteric fractures ( 7- 9). One such new device is the Locking Compression Plate (LCP), an implant plate with a stable angle for management of comminuted and osteoporotic fractures. Although this device is suggested as the gold standard for the treatment of fractures of the proximal femur, there are now various new devices for fracture fixation ( 3). After 30 weeks, 75% of the patients had their normal function restored ( 6). The dynamic compression allows the weight-bearing stresses to stabilize the femur so that it may undergo remodeling and proper fracture healing. The Dynamic Hip Screw (DHS) is a screw that allows for controlled dynamic sliding of the femoral head and is used to fix both the femoral head and the device to the shaft of the femur. There are several devices that may be used for fracture fixation. Operative treatment is the best option in most cases of hip fractures ( 5). The incidence of hip fractures is 2-3 times more common in females and the risk of fracture will double, every 10 years after the age of 50 ( 4). In the elderly, these fractures typically result from mild to moderate trauma due to osteoporotic bones while in young adults, these fractures are generally due to high energy trauma, such as road accidents ( 2). Intertrochanteric fractures of the femur occur between the greater trochanter, the attachment site to the hip abductor and extensor muscles, and the lesser trochanter, the attachment site of the hip flexor muscle ( 3). More than 90% of hip fractures in patients after the 5th decade of age are intertrochanteric fractures with 20-30% of these cases experiencing complications and a mortality rate of approximately 17% ( 1- 3).
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