Treatment of Intertrochanteric Fractures of the Femur using Double Sliding Screws

Han, Suk Ku; Choi, Nam Yong; Lee, Kee Haeng; Park, Seong Jin; Park, Chul

Abstract

PURPOSE
To report the clinical and radiological results of intertrochanteric fractures of femur treated with double sliding screws.
MATERIALS AND METHODS
Twenty-two intertrochanteric fractures of the femur in 22 patients who had at least one year follow-up were included in our study. The age at operation ranged from 25 to 90 years old (average 71.2 years). According to Jensen classification, unstable intertrochanteric fractures were 18 cases (82%). Radiologic assessments were composed of union time, neck-shaft angle, sliding length of lag screws and penetrating length into femoral head of lag screws. Clinical assessments were composed of operation time, amount of postoperative blood loss, length of skin incision and ambulatory ability at one year follow-up according to Koval classification.
RESULTS
Mean fracture healing was done in 16.2 weeks. Postoperative change of neck-shaft angle was 136.3 degree to 134.4 degree. Mean sliding length of lag screw was 3.22 mm and mean penetrating length was 2.13 mm. Mean operation time was 112 minutes. Mean length of skin incision was 16.5 cm and average amount of blood loss counted by baro-vac was 264 mL. Ambulatory ability at one year follow-up was decreased compared to preinjury state. Three cases of reoperations were perfomed due to two cases of varus angulation (9%) and one case of penetration of lag screw into femoral head (4.5%). Two cases of trochanteric bursitis developed by prominent plate.
CONCLUSION
The results of our study indicate that double sliding screw is a useful implant in treating intertrochanteric fractures of the femur. But this system needs more operation time, length of skin incision, postoperative blood loss and skill compared to conventional compression hip screw. So, it is rather the treatment of choice for unstable intertrochanteric fracture of the femur than a stable one.