Hip Pelvis.  2014 Sep;26(3):166-172. 10.5371/hp.2014.26.3.166.

Treatment of Intertrochanteric Fractures Using the Compression Hip Nail

• Yi JM
• Han KY
• Kim KW
• Ryu CH

• KMID: 2054180
• DOI: http://doi.org/10.5371/hp.2014.26.3.166

Abstract

PURPOSE
To investigate the clinical and radiologic outcomes following treatment of intertrochanteric fractures using the Compression Hip Nail(R) (CHN), which has a sliding lag screw.
MATERIALS AND METHODS
Twenty-eight cases of intertrochanteric fractures treated with CHN from November 2012 to October 2013 and followed-up for >6 months were included. The patient population consisted of 11 men and 17 women with a mean age of 75.2 years at the time of surgery. For the initial 11 cases, 10 mm sliding lag screws were used; the remaining 17 cases used 20 mm sliding lag screws. Clinical variables including operation time, amount of transfusion, weight-bearing start time, postoperative physical activity, and complications were investigated. The average sliding of lag screws and the average union were investigated radiologically at 3 and 6 months after surgery.
RESULTS
In an analysis of 23 cases (exclusion of 3 cases of lag screw cutout and 2 cases of nonunion), 11 (48%) recovered their pre-injury activity level. In an analysis of 25 cases (exclusion of 3 cases of cutout), 17 (68%) and 23 (92%) showed radiological union at postoperative months 3 and 6, respectively. Seven complications were noted. Cutout of the lag screw and the lateral protrusion of barrels were significantly greater in the group with 10 mm sliding lag screws as compared to the group using 20 mm sliding lag screws.
CONCLUSION
The use of CHN for the treatment of intertrochanteric fracture yielded poor results. However, results from patients in the 20 mm sliding lag screw group were better than for the 10 mm sliding lag screw group. Therefore, use of the 20 mm sliding lag screw is advisable.

Keyword

Femur; Intertrochanteric fractures; Compression hip nail

MeSH Terms

Female
Femur
Hip Fractures*
Hip*
Humans
Male
Motor Activity
Weight-Bearing

Figure

• 

  Fig. 1 Gross photograph of assembled Compression Hip Nail® (Tradimedics, Seongnam, Korea). (A) Pre-sliding state, the doubleheaded arrow denotes pre-sliding length. (B) Post-sliding state, the arrow denotes lateral protrusion of the lag screw did not occur even when the lag screw slided completely.

• 

  Fig. 2 (A) Immediate postoperative hip anteroposterior radiograph of 80 years old female. (B) Cutout of the lag screw was observed on postoperative 1 month radiograph. (C) Total replacement arthroplasty was done.

• 

  Fig. 3 (A) Hip anteroposterior (AP) radiograph of 82 years old female patient shows unstable intertrochanteric fracture. (B) Immediate postoperative radiograph shows well reduced fracture. (C) Postoperative 6 months, hip AP radiograph shows solid union of fracture and 4.5 mm sliding of lag screw without lateral protrusion of lag screw. White arrows indicate pre- and post-sliding lengths.

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  Fig. 4 (A) Hip anteroposterior (AP) radiograph of 82 years old female patient shows unstable intertrochanteric fracture. (B) Immediate postoperative radiograph. (C) Postoperative 6 months, hip AP radiograph shows lateral protrusion of the barrel.

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