Accuracy of patient reported range of elbow motion

Introduction: A large number of Dynamic Hip Screws (DHS) are performed in our department by surgeons of different grade and experience.The purpose of this audit was to assess our surgical outcomes by calculating the TADs for all the cases performed in a period of 12 months by all grades of surgeons, and determine the rate of cut-out.Methods: Data were collected retrospectively from theatre records.The TADs were calculated as described by Baumgaertner et al.The follow up xrays were reviewed independently and information was obtained regarding the post-op cut-out.Results: One hundred and fifteen patients were identified.TAD varied from 6.56 mm to 37.08 mm with mean 17.27mm.One hundred and one cases (87.8%) had a TAD less than 25mm.Mean TAD was least in the Consultant group and mean follow-up was 9 months.Four hips cut out (3.5%), three of which had a TAD less than 25mm.Conclusions: Surgical grade and therefore experience leads to an improved TAD.The group of surgeons with shortest operative time did not have better TADs.Failure of DHS fixation is multifactorial and hence a TAD less than 25mm does not guarantee that the metalwork will not cut out.