J Korean Hip Soc.  2007 Mar;19(1):58-63. 10.5371/jkhs.2007.19.1.58.

Methods to Increase the Effectiveness of Trochanteric Stabilizing Plate for Unstable Femoral Intertrochanteric Fractures with Gtreater Trochanteric Fracture: Fixation of Greater Trochanter with Wire and Screw

Affiliations
  • 1Department of Orthopaedic Surgery, Kwandong University, College of Medicine, Korea. wonnypia@hanmail.net

Abstract

PURPOSE
The clinical outcome is favorable for the treatment of unstable femoral intertrochanteric fractures using both dynamic hip screw (DHS) and trochanter stabilizing plate (TSP) in elderly patients. However, there are sometimes complications related to excessive sliding. Therefore, the aim of this study was to evaluate the value of additional fixation of greater trochanter using wires and screw in the unstable femoral intertrochanteric fractures with a greater trochanter fracture.
MATERIALS AND METHODS
From March 2004 through December 2005, thirty-seven patients, who were more than sixty-five years of age and were diagnosed with osteoporosis, were treated with DHS and TSP in unstable femoral intertrochanteric fractures with a follow-up of more than 6 months (mean duration, 13.5 months). The patients were divided into two groups. One group (group A: 20 patients) was treated with DHS and TSP only, whereas the other (group B: 17 patients) was treated with DHS and TSP augmented by a wire and screw. The average age was 80.9 (range 68 to 89) and 83.2 years (range 72 to 91) in groups A and B, respectively. All the patients in both groups were assessed radiographically immediately after surgery and at the last follow-up. The level of sliding of the lag screw and displacement of the greater trochanter were evaluated statistically.
RESULTS
Bony union was achieved in all cases except for two cases in group A. At the last follow-up, the average of lag screw sliding in groups A and B was 8.96+/-5.98mm and 4.80+/-3.68, respectively, showing a statistical difference (P value<0.05). The average greater trochnateric displacement in groups A and B was 2.06+/-2.86mm and 0.99+/-1.41mm, respectively, showing no statistical significance (P value>0.05).
CONCLUSION
Unstable femoral intertrochanteric fractures can be treated successfully using a hip screw and TSP alone. However, the addition of wires and screws in the greater trochanter can prevent excessive sliding that occurs after displacing the greater trochanteric fragments out of the plate in the presence of a greater trochanteric fracture line or severe bone defect in the lateral aspect.

Keyword

Unstable femoral intertrochanteric fracture; Fracture of greater trochanter; DHS; TSP

MeSH Terms

Aged
Femur*
Follow-Up Studies
Hip
Hip Fractures*
Humans
Osteoporosis

Cited by  3 articles

Fixation of the Greater Trochanter in Arthroplasty for Unstable Intertrochnateric Fracture
Dong-Hyeok Choi, Ju-Yeong Heo, Young-Jae Jang, Young-Yool Chung
J Korean Fract Soc. 2014;27(1):58-64.    doi: 10.12671/jkfs.2014.27.1.58.

A Comparison of Intramedullary and Extramedullary Fixations for the Treatment of Reverse Oblique or Transverse Intertrochanteric Femoral Fractures
Yerl-Bo Sung, Jung-Yun Choi, Eui-Yub Jung
Hip Pelvis. 2012;24(2):109-116.    doi: 10.5371/hp.2012.24.2.109.

Additional Fixations for Sliding Hip Screws in Treating Unstable Pertrochanteric Femoral Fractures (AO Type 31-A2): Short-Term Clinical Results
Su Hyun Cho, Soo Ho Lee, Hyung Lae Cho, Jung Hoei Ku, Jae Hyuk Choi, Alex J Lee
Clin Orthop Surg. 2011;3(2):107-113.    doi: 10.4055/cios.2011.3.2.107.

Full Text Links
  • JKHS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr