Treatment of an Unstable Intertrochanteric Fracture of The Femur Using a PMMA Augmented Compression Hip Screw

Kwon, Soon Yong; Chung, Do Hyun; Rhee, Kyung Jin; Woo, Young Kyun; Kim, Yong Sik

Abstract

PURPOSE
The aim of this study was to evaluate the clinical and radiological results of a PMMA augmented compression hip screw for the management of unstable intertrochanteric fractures of the femur in senile patients. MATERIALS AND METHODS: From May 1996 to May 2002, 30 patients (mean age 74.8 years, ranging from 51 to 89) with an unstable intertrochanteric fracture of the femur, were treated with a PMMA augmented compression hip screw. The average follow-up period was 16.8 months (12 to 36). Radiologically, the degrees of osteoporosis, the neck-shaft angle after the reduction, the position of lag screw in the femoral head, the degrees of sliding of the lag screw and the shortening of the limb when union had been achieved, the extent of the insertion of the PMMA cement, and the timing of bone union were analyzed. In addition, the changes in the ambulatory capacity were evaluated by the functional class of Koval. RESULTS: Radiologically, 5 cases of a varus deformity over 10degrees and 7 cases of lag screw sliding more than 15 mm were found in the 30 cases. However, there was no cutting out of the screw in femoral head nor was there fixation failure of the plate. In addition, union was finally achieved in all cases, although there were two cases of a delayed union. Clinically, satisfactory results were obtained in most of the cases according to the functional class of Koval. CONCLUSION: For senile patients with an unstable intertrochanteric fracture of the femur, PMMA augmented compression hip screw appears to be one of the more useful methods allowing the early ambulation and reducing the number of complications by the long immobilization.