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KMID : 0386420160290030192
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Journal of the Korean Fracture Society
2016 Volume.29 No. 3 p.192 ~ p.199
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Surgical Treatment for Stable 2-Part Intertrochanteric Femur Fracture Using Dynamic Hip Screw with 2-Hole Side Plate in Elderly Patients
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Lee Kyung-Hoon
Han Suk-Ku
Chung Seung-Jae
Noh Jong-Ho
Lee Gi-Haeng
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Abstract
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Purpose: The purpose of this study is to evaluate the postoperative outcomes of elderly patients with stable 2-part intertrochanteric femur fractures surgically treated using dynamic hip screw with 2-hole side plate.
Materials and Methods: From February 2008 to January 2014, 50 patients older than the age of 65 years, who had been followed-up for more than 6 months after the operation at The Catholic University of Korea, Bucheon St. Mary's Hospital were enrolled. A clinical evaluation of the skin incision length, operating time, and ambulatory status, using Clawson's Ambulation Capacity Classification, was performed, and a radiologic evaluation of Fogagnolo reduction quality, tip-apex distance (TAD), Cleveland index, sliding extent of lag screws, time duration till bony union, and complications was also done.
Results: The mean skin incision length was 9.8 cm (range, 8-13 cm), the mean operating time was 41.4 minutes (range, 30-60 minutes), and 32 patients recovered their ambulatory function. Forty-eight patients gained bony union, and the time lapsed till union was average 10.6 weeks (range, 8-16 weeks). The evaluation of postoperative radiologic images showed the following reduction statuses by the Fogagnolo classification: 46 cases of "Good", 3 cases of "Acceptable," and 1 case of "Poor." Moreover, the mean TAD was 18.9 mm (range, 9.0-24.9 mm). While 45 cases fit into the zone 5 of the Cleveland index, other 3 were within zone 8 and the other 2 were within zone 6. The mean sliding length of the lag screws were 4.9 mm (range, 0.1-19.4 mm). There were a case of nonunion and a case of periprosthetic infection with nonunion as complications.
Conclusion: Using dynamic hip screws with 2-hole side plate for stable 2-part intertrochanteric femur fractures in elderly patients showed satisfactory results with respect to the recovery of ambulatory functions and bony union.
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KEYWORD
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Femur, Intertrochanteric fractures, Dynamic hip screw, 2-hole side plate
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