Surgical fixation of hip fractures– a novel technique for pre-operative planning

Abstract Purpose The dynamic hip screw (DHS) is a widely used method for hip fracture stabilisation, but conventional DHS (CHDS) fixations may be limited by longer surgical duration and delayed recovery compared to minimally invasive DHS (MIDHS) fixations. We describe a novel low-cost surgical metho...

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Main Authors: Zi Qiang Glen Liau, Kamaraj Thirukumaran, Seth Ian Sim, Alexander Shao-Rong Pang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-025-05803-2
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author Zi Qiang Glen Liau
Kamaraj Thirukumaran
Seth Ian Sim
Alexander Shao-Rong Pang
author_facet Zi Qiang Glen Liau
Kamaraj Thirukumaran
Seth Ian Sim
Alexander Shao-Rong Pang
author_sort Zi Qiang Glen Liau
collection DOAJ
description Abstract Purpose The dynamic hip screw (DHS) is a widely used method for hip fracture stabilisation, but conventional DHS (CHDS) fixations may be limited by longer surgical duration and delayed recovery compared to minimally invasive DHS (MIDHS) fixations. We describe a novel low-cost surgical method that reduces intraoperative time, peri-operative complications, and improves overall patient outcomes. Methods A prospective double-blinded study included 15 patients who underwent surgical fixation of IT hip fractures using a 4-hole DHS system. All surgeries were performed at a tertiary referral hospital between January 2019 and April 2023 by surgeons with similar levels of experience. Main outcome measurements included tip-apex distance (TAD), surgery duration, haemoglobin loss, and hospital stay duration. Two independent assessors measured TAD using the post-operative anteroposterior and lateral radiographs. Kyle’s classification was used to categorize the IT fractures. IBM SPSS Statistics 26.0 for Mac (SPSS, Chicago, IL, USA) was used for the statistical analysis. Statistically significant difference was defined as p-value < 0.05. Results Both groups had similar baseline characteristics (p > 0.05). Both groups had similar complexity in fractures, but the mean surgical duration was significantly shorter (p = 0.019) (43.8 ± 12.3 min) compared to the CDHS group (73.4 ± 18.2 min). Postoperatively, there was no significant difference (p > 0.05) in hospital stay duration, haemoglobin (Hb) loss, or TAD. Conclusions MIDHS group had shorter surgical duration compared to CDHS group, with no significant difference in TAD, haemoglobin loss and hospital stay duration.
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spelling doaj-art-bde09d7908004584b67965f3090cdcf62025-08-20T02:17:58ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-04-0120111010.1186/s13018-025-05803-2Surgical fixation of hip fractures– a novel technique for pre-operative planningZi Qiang Glen Liau0Kamaraj Thirukumaran1Seth Ian Sim2Alexander Shao-Rong Pang3Department of Orthopaedic Surgery, National University HospitalYong Loo Lin School of Medicine, National University of SingaporeDepartment of Orthopaedic Surgery, National University HospitalYong Loo Lin School of Medicine, National University of SingaporeAbstract Purpose The dynamic hip screw (DHS) is a widely used method for hip fracture stabilisation, but conventional DHS (CHDS) fixations may be limited by longer surgical duration and delayed recovery compared to minimally invasive DHS (MIDHS) fixations. We describe a novel low-cost surgical method that reduces intraoperative time, peri-operative complications, and improves overall patient outcomes. Methods A prospective double-blinded study included 15 patients who underwent surgical fixation of IT hip fractures using a 4-hole DHS system. All surgeries were performed at a tertiary referral hospital between January 2019 and April 2023 by surgeons with similar levels of experience. Main outcome measurements included tip-apex distance (TAD), surgery duration, haemoglobin loss, and hospital stay duration. Two independent assessors measured TAD using the post-operative anteroposterior and lateral radiographs. Kyle’s classification was used to categorize the IT fractures. IBM SPSS Statistics 26.0 for Mac (SPSS, Chicago, IL, USA) was used for the statistical analysis. Statistically significant difference was defined as p-value < 0.05. Results Both groups had similar baseline characteristics (p > 0.05). Both groups had similar complexity in fractures, but the mean surgical duration was significantly shorter (p = 0.019) (43.8 ± 12.3 min) compared to the CDHS group (73.4 ± 18.2 min). Postoperatively, there was no significant difference (p > 0.05) in hospital stay duration, haemoglobin (Hb) loss, or TAD. Conclusions MIDHS group had shorter surgical duration compared to CDHS group, with no significant difference in TAD, haemoglobin loss and hospital stay duration.https://doi.org/10.1186/s13018-025-05803-2FemurIntertrochanteric fracturesDynamic hip screw fixationMinimally invasive surgery
spellingShingle Zi Qiang Glen Liau
Kamaraj Thirukumaran
Seth Ian Sim
Alexander Shao-Rong Pang
Surgical fixation of hip fractures– a novel technique for pre-operative planning
Journal of Orthopaedic Surgery and Research
Femur
Intertrochanteric fractures
Dynamic hip screw fixation
Minimally invasive surgery
title Surgical fixation of hip fractures– a novel technique for pre-operative planning
title_full Surgical fixation of hip fractures– a novel technique for pre-operative planning
title_fullStr Surgical fixation of hip fractures– a novel technique for pre-operative planning
title_full_unstemmed Surgical fixation of hip fractures– a novel technique for pre-operative planning
title_short Surgical fixation of hip fractures– a novel technique for pre-operative planning
title_sort surgical fixation of hip fractures a novel technique for pre operative planning
topic Femur
Intertrochanteric fractures
Dynamic hip screw fixation
Minimally invasive surgery
url https://doi.org/10.1186/s13018-025-05803-2
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AT sethiansim surgicalfixationofhipfracturesanoveltechniqueforpreoperativeplanning
AT alexandershaorongpang surgicalfixationofhipfracturesanoveltechniqueforpreoperativeplanning