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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 1999 April;50(2):53-8
The surgical and rehabilitative treatment of femoral fractures with DMS screw plate synthesis in the elderly
Molinar Min A. M., Iacomussi T., Sobrino G.
Background. This study aimed to evaluate the therapeutic efficacy of the DMS screw plate in the treatment of fractures of the proximal femoral extremity.
Methods. DMS is a sliding and compression screw plate, but unlike other similar means of synthesis, it is possible to alter the angle between the diaphyseal and cephalic parts from 85 to 155 degrees. From November 1993 to February 1998 a total of 1000 proximal femoral fractures (456 medial and 544 pertrochanteric lateral) were treated at the Orthopedics and Traumatology Division of Maria Vittoria Hospi-tal in Turin. The DMS screw plate was used in 270 lateral fractures; the mean age of patients treated was 77.5 years old (range 16 - 102 years). The right side was affected in 145 cases and the left in 125. The following parameters were evaluated: operating time, blood loss, consolidation time and any complications. A group of 90 patients were studied during rehabilitation and evaluated according to ADL and subdivided into four categories.
Results. Sixty-five patients were assessed as good to excellent, 10 were satisfactory and 15 unsatisfactory.
Conclusions. The analysis of the results regarding surgical and rehabilitative aspects confirmed the value of this means of synthesis in pertrochanteric femoral fractures, enabling a simplification of the operating technique that guarantees optimal synthesis, early load-bearing and an easier rehabilitative programme.