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2026, Number 4

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Acta Med 2026; 24 (4)

Relation between femoral offset loss and walking ability in eldery with transtrochanteric fractures operated with a dynamic hip screw plate

Vázquez TCF, Braña RK, Mora RFG, Domínguez GRC

Language: Spanish
References: 20
Page: 389-394
PDF size: 1185.27 Kb.


ABSTRACT

Introduction: transtrochanteric hip fractures in older adults are associated with high morbidity, mortality, and impaired gait. Femoral offset (FO) influences hip biomechanics, yet its role after dynamic hip screw (DHS) fixation remains unclear. Objective: to assess the association between postoperative FO and gait recovery at 8-12 weeks in patients with transtrochanteric fractures treated with DHS. Material and methods: retrospective, descriptive, transversal study of 103 patients ≥ 60 years who underwent surgery between January-October 2022. FO was measured radiographically by two surgeons and gait ability was registered. Results: 77.7% regained ambulation. Mean FO ranged from 30.3-30.5 mm, with excellent interobserver agreement (p = 0.83). Greater FO correlated negatively with femoral shortening (p < 0.001). A FO ≥ 27.5 mm predicted successful ambulation, with 87.5% sensitivity and 95.7% specificity (area under the curve [AUC] = 0.979). Increased shortening was significantly associated with gait recovery failure (p = 0.0245). Conclusion: FO is a key prognostic radiographic parameter. Restoration to ≥ 27.5 mm should be a surgical priority to optimize gait outcomes in elderly patients undergoing DHS fixation for transtrochanteric fractures.


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