الفهرس 
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Abstract
In this study, one hundred twenty three of patients with unstable trochanteric fractures (23 of them were managed between Octobor 2010 to Agust 2011), and one hundred of patients with unstable trochanteric fractures were previously managed by the main supervisor (retrospectivly), all were assessed and followed up. All cases were treated, using fixation device featuring a Dynamic derotation plate with D.H.S.
The Salvati and Wilson hip function scoring system used to evaluate the results clinically, according to it : 59 patients had excellent results , 53 had good results, 8 fair had results , and three had poor results, these results were better than published results of unstable trochanteric fractures treated by DHS alone and were comparable with the results of published series on unstable trochanteric fractures fixed by TSP superimposed DHS. In addition, using DDP, involved no massive soft tissue dissection, easy application, short operative and radiation time, derotation screw fixed angle in coronal and sagittal planes, absolutely parallel to DHS (allowing axial loading, load sharing), and less cost.
Follow up duration for the prospective group of patients ranged from 6 months to 12 months (mean 9 months), and for the retrospective group of patents ranged from 6 months to 6 years (mean 2 years).
All cases united within two to six months with average 2,5 months. Average time of operation was 55 minutes, there was no need for blood transfusion, only three cases who were complicated and needed further intervention (2.4%).
Such intertrochanteric fractures (unstable) can be managed either with a dynamic screw-plate type fixation, or with the Dynamic derotation plate with the DHS.Most published clinical studies of screw-plate fixations have generally reported satisfactory results except for unstable fractures. This study showed that this implant design significantly enhance the anatomical result and functional outcome of these fractures, resulting in an earlier recovery of patient’s walking ability.
We concluded that the Dynamic derotation plate with the DHS produced better results in treatment of unstable trochanteric fractures as it offered a solution for:
1-Lateral wall support.
2-Fixed angle derotation screw.
And these were the main two causes of faliuer suggested in the litratures.
The DDP maintains the agreed for mechanical advantages of DHS as controlled impaction and similarly, low rate of morbidity and mortality.