J Korean Fract Soc.  2013 Jan;26(1):44-49. 10.12671/jkfs.2013.26.1.44.

A Comparison between Compression Hip Screw and Intramedullary Nail for the Treatment of AO/OTA A2.2 Intertrochanteric Femoral Fracture

• Chung PH
• Kang S
• Kim JP
• Kim YS
• Lee HM
• Kim JH

• KMID: 1431716
• DOI: http://doi.org/10.12671/jkfs.2013.26.1.44

Abstract

PURPOSE
To compare the result between the compression hip screw (CHS) and intramedullary (IM) nail for the treatment of AO/OTA A2.2 intertrochanteric fracture.
MATERIALS AND METHODS
We retrospectively reviewed 95 cases of AO/OTA A2.2 intertrochanteric fracture, which were treated with CHS or IM nail by one surgeon from March 1994 to December 2009. One group was treated with CHS (Group I, 28 cases) and the other was treated with IM nail (Group II, 67 cases). We evaluated the mean operation time, the amount of bleeding and transfusion, hospital duration, radiological results and the clinical outcome with the mobility score of Parker and Palmer.
RESULTS
Radiologically, the tip-apex distance, change of neck-shaft angle, and union time were not significantly different between both groups (p>0.05). Clinically, the mean operation time, the amount of bleeding and transfusion, hospital duration and the mobility score were not significantly different (p>0.05). The post-operative complications were lag screw slippage over 25 mm (1 case) and loosening of device (1 case) in group I. In group II, there were perforation of the femoral head (1 case), nail breakage (1 case) and deep infection (1 case).
CONCLUSION
There was no significant differences that are clinical and radiological results in the treatment of AO/OTA A2.2 intertrochanteric fracture, using CHS and IM nail.

Keyword

Femur; Intertrochanteric fractures; Compression hip screw; Intramedullary nailing

MeSH Terms

Femoral Fractures
Femur
Fracture Fixation, Intramedullary
Head
Hemorrhage
Hip
Hip Fractures
Nails
Retrospective Studies

Figure

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  Fig. 1 (A) A sixty seven-year-old woman sustained left hip fracture. (B) The fracture type was AO/OTA 31-A2.2 which was confirmed by 3-dimensional computed tomography scan. (C) The fracture was closely reduced and fixed with compression hip screw. (D) Final follow-up radiograph shows solid union and 5 mm lag screw sliding.

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  Fig. 2 (A) A seventy nine-year-old man sustained left intertrochanteric femoral fracture. (B) The fracture type was AO/OTA 31-A2.2 which was confirmed by 3-dimensional computed tomography scan. (C) The fracture was closely reduced and fixed with intramedullary nail. (D) Final follow-up radiographs show solid union without lag screw sliding.

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