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KMID : 0386420070200020129
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Journal of the Korean Fracture Society
2007 Volume.20 No. 2 p.129 ~ p.134
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Trochanteric Management for Unstable Intertrochanteric Femoral Fracture in the Elderly Patients
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Kho Duk-Hwan
Shin Ju-Yong
KIm Ki-Hwan
Lee Jun-Hyuck
Kim Dong-Heon
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Abstract
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Purpose: To evaluate the results after fixation with figure of eight and cerclage wiring for com m inuted trochanteric fracture. Because com m inution of the fem oraltrochanteric fracture in elderly patients is severer in the operating field than x-ray findings, so the fixation is m ore difficult.
Materials and Methods: Between M arch 1998 and M arch 2004, the clinical records on twenty-eight patients m ore than 70 years old who underw ent the bipolar hem iarthroplaty using calcar replacem ent type of fem oral stem and followed m ore than 24 m onths were review ed. Figure of eight and cerclage wiring was used for the com m inuted trochanteric fracture of the fem oral intertrochanteric fracture. The m ean age was 80.4 (70∼103) years. 19 cases were fem ale, 9 cases were m ale. M ean follow-up period was 58 (24∼92) m onths. W e evaluated the results by m odified H arris hip score, walking ability, activity of daily living, radiologic findings and union of the fracture.
Results: The m ean duration of bony union w as 12 w eeks. The m ean postoperative m odified H arris hip score was 82.3. Preoperative walking ability was recovered in 23 cases (82% ). Also basic activity of daily living was recovered in 22 cases (79% ). Nonunion of trochanter was found in only one case by radiologic evaluation but clinical correlation was not significant.
Conclusion: W e consider fixation with figure of eight and cerclage wiring for unstable intertrochanteric fracture of fem ur in the elderly patientis m ore appropriate in term s ofconvenience offixation,duration ofunion,early am bulation and costeffectiveness.
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KEYWORD
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Comminuted trochanteric fracture, Figure of eight and cerclage wiring, Bipolar hem iarthroplasty
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