Risk Factors for Implant Failure After Dynamic Hip Screw Fixation of Intertrochanteric Fractures in Elderly Patients at Teaching Hospitals in North East Nigeria

Intertrochanteric femoral fractures are common in the elderly and are associated with significant mortality and functional decline. The dynamic hip screw (DHS) remains widely used for their fixation, but implant failure remains a significant concern, particularly in patients with poor bone quality. This multicentre retrospective cohort study identifies risk factors for implant failure following DHS fixation of intertrochanteric fractures in patients aged 60 years and above at University of Maiduguri Teaching Hospital and Federal Medical Centre, Nguru, North East Nigeria, over a four-year period. Case records will be reviewed for patient demographics, fracture classification (AO/OTA), tip-apex distance (TAD), bone density estimation, screw position (calcar-referenced tip-apex distance), time to weight-bearing, and implant failure events including cut-out, bending, and breakage. Binary logistic regression will identify independent predictors of failure. The study hypothesises that a tip-apex distance exceeding 25mm and varus reduction are the strongest predictors of cut-out failure. Findings will be submitted to the orthopaedic departments at both institutions and published in a peer-reviewed regional journal to inform technical refinements in DHS fixation across North East Nigeria. Keywords: dynamic hip screw, implant failure, intertrochanteric fractures, tip-apex distance, elderly.