Surgical management of intertrochanteric fracture femur by sliding hip screw and its assessment using Salavati-Wilson criteria

Introduction: Intertrochanteric (IT) fractures constitute a huge threat to life, untreated condition may cause a considerable change in quality of life, existing disease gets worsen and may results in mortality. Considering the complexities of treating of these fractures, present study primarily focuses on management of trochanteric fracture by sliding hip screw. This study attempts to highlight the outcome of this procedure using Salvati-Wilson criterion and does not intend to compare with any other modality of fixation.

Material and Methods: A prospective observational study conducted on fifty patients which were followed-up at intervals of two, six, twelve and twenty-four weeks post-operatively. Clinico-radiological and functional outcome at twenty-four weeks post-operatively were analyzed using Salvati-Wilson criteria.

Results: Majority of the patients were females (68%). Mean age of patients were 70.8 ± 9.19 years. No statistically significant difference was found between the Salvati-Wilson score among age group, sex, side of the fracture, screw length, and number of holes. However, significant difference was seen between Tip Apex Distance (TAD), intra and post-operative complication, partial and full bearing walk, radiological union days and AO class (p-value < 0.05).

Discussion: In present study, TAD was recorded with range of 19 to 28 mm with a mean of 22.78 mm. Using Salvati Wilson score at six months based on pain, walking, muscle power & motion and function there were 26% excellent, 52% good, 20% fair and 2% poor cases were identified in our follow up of the fractures treated with sliding hip screw and barrel plate assembly osteosynthesis.

Conclusion: Complex intertrochanteric fractures can be treated with SHS construct with good functional outcomes as measured by Salvati-Wilson criterion.