J Korean Hip Soc.  2010 Sep;22(3):216-221. 10.5371/jkhs.2010.22.3.216.

Treatment of Intertrochanteric Fracture of the Femur Using a Dyna Locking Trochanteric (DLT) Nail

• Kim YS
• Yoon JW
• Han SK

• KMID: 1461173
• DOI: http://doi.org/10.5371/jkhs.2010.22.3.216

Abstract

PURPOSE
We analyzed the clinical and radiological results after treatment of intertrochanteric fracture of the femur using a Dyna locking trochanteric (DLT) nail.
MATERIALS AND METHODS
From March 2008 to February 2009, 36 patients (10 males and 26 females) who had at least 6 months follow-up among 43 patients were included in our study. The average age of the patients was 76.4 years (range: 65~90 years) and the average follow-up period was 13.4 months (range: 9~21 months). We evaluated the radiological results such as the neck-shaft angle and the sliding length of the lag screw at last follow-up and the clinical results such as intraoperative complications, the operation time, the postoperative blood loss and the incidence of fixation failure.
RESULTS
The average neck-shaft angle at last follow-up was 131.1 degrees and the average sliding length of lag screw was 3.6 mm. Two cases (5.6%) of femoral shaft fracture during the insertion of a lag screw or nail happened and one case of stress fracture of the femoral neck occurred. Two cases of fixation failure developed due to deep infection or varus angulation.
CONCLUSION
Fixation using a DLT nail can be a good option for the treatment of intertrochanteric fractures of the femur.

Keyword

Femur; Intertrochanteric fracture; Dyna locking trochanteric nail

MeSH Terms

Femur
Femur Neck
Follow-Up Studies
Fractures, Stress
Hip Fractures
Humans
Incidence
Intraoperative Complications
Male
Nails
Postoperative Hemorrhage

Figure

• 

  Fig. 1 78 year-old female injured her right hip fracture by fall. (A) Initial radiograph showed comminuted intertrochanteric fracture with loss of lateral buttress (A3.3 AO/OTA). (B) The operation was performed with DLT nail fixation. (C) At 6 months after operation, the fracture was united.

• 

  Fig. 2 74 year-old male injured left intertrochanteric fracture (A1.1 AO/OTA). (A) Initial film showed a minimally displaced intertrochanteric fracture. (B) The fracture was fixed with DLT nail. (C) The radiograph at postoperative 6 months showed a sclerotic line at head-neck junction and healed state of intertrochanteric fracture. (D) Bone scans showed increased isotope uptake in left medial femoral neck and trochanter. (E) After removal of nail, a subcapital stress fracture was observed by computed tomography. (F) A bipolar hemiarthroplasty was performed at postoperative 7 months.

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