الفهرس 
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Abstract
Our present study was conducted in the department of Orthopedics, sohag university hospital during the period between September 2013 and July2014.
Twelve patients of intertrochanteric fractures managed operatively by internal fixation with selfdynamizable internal fixator (SIF) during the course of the study and each was followed for at least 6 months.
Follow up of all patients were carried out regularly with clinical and radiological assessment till 6 months postoperatively. The data thus collected from patients was analyzed, evaluated.
Our aim was to evaluate the results of using selfdynamizable internal fixator (SIF) in treatment of intertrochanteric fractures.
All the patients were examined clinically and radiological, including detail history of pre morbid status at the time of admission. Patients fulfilling the inclusion criteria was only included in the study.
Mean age in years = 72.4
There was a male preponderance in our patients. A male to female ratio in all patients was about 2:1.
Most common mode of injury in older patients is the simple fall (domestic fall) whilein young patients, falling from height is most common mode of injury.
Amongst the 12 cases operated by SIF, 5(41.7%) patients were found to have intertrochanteric fractures on the right side while 7(58.3%) patients were having fracture on the left side.
Majority of patients in present study series were operated within 5 days following admission in hospital.
In all patients,one patient was found to have chest infection ,One patient was found to have urinary tract infection(UTI),3 patients were found to have diabetes mellitus and their blood glucose was controlled preoperatively, one case of them had diabetic ketoacidosis postoperatively and died one week later after control of blood glucose. The patients with chest infection were known cases of COPD, as they were chronic smoker.
Two cases died.
Superficial would infection was seen in one case.
Nocases had a revision operation.
In one case operated by SIF we found difficulty in reduction. This was due to delay in surgery as the patient presented with a co-morbid condition(Diabetes).Limitation of hip external rotationmore than20° was not noticed in our cases. Varusdeformity was noted in threecases (25%). This could be due to the pull of the muscle onto distal shaft fragment which has the tendency to migrate upwards thus resulting in varus deformity.
Shortening wasobservedin three patients.
In present study, We have encountered slightbacking out of the proximal screws in three cases.
Mobilization: we allow the patient to walk during the first 3 weeks bearing limited weight which did not exceed the weight of the patient’s leg. After that time, weight-bearing was progressively increased until full weight-bearing was introduced 8 weeks after the operation. In simple fractures it is allowed immediate full weight bearing .
Average time of fracture union: Average time of union in all our patients was about 12weeks. (Range:8 to 16 weeks).
Range of Movement (According to Harris Hip Scoring system) The range of motion that is flexion, abduction, internal and external rotations were good to excellent in most of the cases operated by the device. There were fair results in one cases. Itwas attributed to the poor compliance of the patients for regular physiotherapy and also due poor reduction achieved at the time of surgery thus not getting the best possible result.
CONCLUSION
The use of the SIF was proven to be safe and successful for treating intertrochanteric fracture. It provides a short operative time, low blood loss, spontaneous biaxial dynamization and healing in an optimal period of time without secondary intervention. For all patients full weight bearing can be allowed shortly after surgery without the complications that accompany the other implants.