Comparative evaluation of DCS implant failure rate in subtrochanteric fractures in patients over 60 years old referred to Shohada Hospital in Spring and Summer 2019

Abstract

Subtrochanteric femoral fractures in elderly patients are affected by various factors such as osteoporosis and other diseases affecting bone healing and even the quality of implant function. The aim of this study was to evaluate the failure rate of DCS implants in stabilizing subtrochanteric femoral fractures and to compare the results between the two age groups under and over 60 years. Materials and Methods: In this prospective cross-sectional study, patients with sub-trochanteric femoral fractures who underwent DCS implantation were enrolled among those referred to Tabriz Shohada subspecialty clinics. Patients' clinical records were extracted. Demographic information of patients including age and sex along with other information such as activity and movement before and after surgery and osteoporosis, underlying diseases (diabetes, hypertension, hyperlipidemia, etc.) were recorded by the project manager. Also, by examining the preoperative graphs, intertrochanteric fractures were differentiated from subtrochanteric fractures and were excluded from the study. Results: The mean age of the patients was 61.54±14.84 years. The results of the present study showed that in evaluating the rate of DCS implant failure in patients under 60 years of age, there were 2 cases (8%) and in patients over 60 years of age, there were 13 cases (52%) of DCS failure. There was a statistically significant difference between the two groups in terms of DCS failure rate (p=0.003). Based on the results, it was observed that in the group of patients under 60 years of age, there were two cases of DCS failure, both of which were caused by Metal Failure and were not related to the underlying disease. In contrast, in patients over 60 years of age, the underlying disease was significantly associated with DCS failure. Osteoporosis was the most common cause of DCS failure. Logistic regression analysis also showed that risk factors for DCS failure include diabetes, hypertension, osteoporosis, and age over 60 years.