Minimally invasive dhs (midhs) does it really make a difference?: a comparison of a novel technique at a tertiary care trauma centre

Aim: The purpose of the study was to compare Minimally Invasive DHS (MIDHS) or Conventional DHS (CDHS) techniques for surgical parameters affecting treatment of Extra capsular Proximal Femur fractures. Methods: Prospective Case Control study have evaluated 108 extracapsular proximal femur fractures operated upon between Feb 2014 to March 2016. Patients presenting to the Orthopaedic Surgery department with Extra Capsular Proximal Femoral Fractures who were treated with Minimally Invasive DHS (MIDHS) were compared with those who presented in the same time frame but were managed using Conventional DHS (CDHS) using a muscle reflecting lateral approach. The two groups were matched for pre-operative parameters such as age and gender distribution, mechanism of injury, patient comorbids, classification of fracture pattern. The two groups were compared for incision size and operative time. Postoperative outcome measures were analgesia requirement, Visual Analog Score for pain, accuracy of reduction and lag screw positioning as well as drop in Haemoglobin level and transfusion requirement. Hip functional scores (Katz Basic Activities of Daily Living - BADL) and (Harris Hip Functional Score) were also compared following the two procedures. Results: 97 patients met the inclusion criteria. Out of these 5 patients were lost in the followup, 3 due to death and 2 due to change in address and contact details. Out of the 92 patients that remained in the study MIDHS technique was employed in (n=40) cases and CDHS was done for (n=52) patients. Conclusion: In view of our findings we conclude that MIDHS significantly minimizes blood loss and transfusion requirement and reduces postoperative pain giving a much more cosmetically sized scar while not compromising on, operative time, accuracy of reduction and postoperative hip function.