In the treatment of elderly hip fracture, early mobilization as a means of reducing early postoperative morbity and mortalithy is mandatory. For the treatment of the senile unsable intertrochanteric fracture, the Compression hip screw is
like to.
However, for the instability and comminution of the posteromedial fragment of the proximal femur, subsequent loss of fixation, head perforation, nouunion and implanr failure were developed. To prevent these difficult problems, we have
used
proximal wiring technique with compression Hip screw since 1989, The 21 cases were available with minimum follow-up of six months, which was healed radiologically and clinically.
1. Of 21 cases of trochanteric fracture mean age was 70 years old(range 32-89 years old) and sex distribution showed 11 cases of female and 10 cases of male.
2. The radioloical morphometry using Singh index were showed: 11 cases had poor bone quality(below Grade III) and the fracture type classified by Kyle method showed the 16 cases of type III and 5 cases of type IV.
3. Inoperation method, we performed anatomical reduction of the fracture as possible and two circumferential wire were inserted through the large posteromedial fragment including as lesser trochanter, and Compression Hip screw was done
as
usual manner under imaginary intensifier, then prevention of the fracture site, under imagenary inten sifier, we performed circlage wiring, which through the posteromedial fragment with the compression hipscrew.
4. For measeure thescrew sliding between the immediate post-of x-ray and last follow-up X-ray, Doppilt's method was used. And measure the angular deformity, neck-shaftangle was used with correction factor.
5. We analysed the 21 cases with proximal wiring technique and showed good results. So, we recommended that proximal wiring technique with Compression hip screrw in the treatment of the unstable trochanteric fracture to prevent the complication
of the
Compression Hip0 Screw, for the instabiloty of the posteromedial fragments.
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