J Korean Fract Soc.  2001 Jan;14(1):23-29.

The Neccessity of Additional Supporting Fixation for the Unstable Intertrochanteric Fractures of the Femur in the Elderly

• Cho HO
• Kwak KD
• Sohn SM
• Kang CH
• Whang SI
• An SM
• Lee DY

Abstract

PURPOSE
This study was designed to assess the necessity of additional supporting fixation to the traditional internal fixation for unstable intertrochanteric fractures of femur.
MATERIALS AND METHODS
Seventy two cases of unstable intertrochanteric fractures (modified Boyd-Anderson type III, IV) in the elderly were reviewed, which were internally fixed with Dynamic Hip Screw. 48 cases were treated with Dynamic Hip Screw only(Group I) and 24 cases with Dynamic Hip Screw and additional trochanteric supporting plate(Group II). In 13 cases with weak femoral cortx, we added wiring to the side plate. We measured neck-shaft angle, degrees of displacement of greater trochanteric fragment, slippage of hip screw on plain radiographs.
RESULTS
Varus change in neck-shaft angle, displacement of greater trochanteric fragment and slippage of hip screw revealed 7.3°, 5.4 mm, and 10.7 mm respectively in group I, while 2.1°, 0.1 mm and 3.8 mm respectively in group II. There were no pullout of cortical screws.
CONCLUSION
Internal fixation with additional trochanteric supporting plate to the conventional Dynamic Hip Screw was effective in unstable intertrochanteric fractures of the femur in the elderly. Added wiring to the side plate was also helpful in weak femoral cortex.

Keyword

Femur; Intertrochanteric fracture; Unstable; Elerly; Additional fixation; Trochanteric supporting plate

MeSH Terms

Aged*
Femur*
Hip
Hip Fractures*
Humans