J Korean Fract Soc.  2014 Jan;27(1):36-41. 10.12671/jkfs.2014.27.1.36.

Unstable Intertrochanteric Fracture Treated with ITST: A Comparative Study between Groups with and without Comminution of Greater Trochanter

• Song KS
• Lee SH
• Jeong SH
• Lee SK
• Hong SH

• KMID: 1817000
• DOI: http://doi.org/10.12671/jkfs.2014.27.1.36

Abstract

PURPOSE
To evaluate whether the radiological and clinical results of treatment with intertrochanteric/subtrochanteric (ITST) nail on unstable intertrochanteric fractures are combined with comminution of the greater trochanter or not.
MATERIALS AND METHODS
We reviewed the results on 210 cases of unstable intertrochanteric fractures (grouped 88 patients with comminution of greater trochanter [GT] and 122 patients without comminution of GT) treated with ITST nail from January 2007 to October 2011, which was to be followed-up for more than 12 months.
RESULTS
The mean union time was 15.2 weeks in the study group (combined with comminution of GT). The mean union time was 14.7 weeks in control group (no comminution of GT). The lag screw sliding was 8.7 mm in the study group and 7.2 mm in the control group. Changes of neck-shaft angle was 4.2degrees in study group and 4.1degrees in control group. Tip-apex distance was 17.4 mm in study group and 16.4 mm in control group. The complications were 4 cases in each study group and control group. The clinical results checked by Skovron recovery scores decreased similarly in both groups, 73.7% in study group and 76.5% in control group. There were no significant differences in both groups according to radiological and clinical results.
CONCLUSION
The comminution of great trochanter does not affect on the radiological and clinical results when using the ITST nail of unstable intertrochanteric fractures.

Keyword

Femur; Unstable intertrochanteric fracture; ITST

MeSH Terms

Femur*
Hip Fractures
Humans

Figure

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  Fig. 1 (A) Preoperative radiographs of a 74-year-old female show an unstable intertrochanteric fracture with comminution of the greater trochanter. (B) Preoperative computed tomography shows comminution on the greater trochanter. (C) Postoperative 4-months radiographs show the complete union without deformity.

• 

  Fig. 2 (A) Preoperative radiographs of a 61-year-old female show an unstable intertrochanteric fracture without comminution of the greater trochanter. (B) Preoperative computed tomography shows no comminution on the greater trochanter. (C) Postoperative 2-months radiographs show the complete union without deformity.

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