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KMID : 0386720010130040346
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Journal of the Korean Hip Society
2001 Volume.13 No. 4 p.346 ~ p.351
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Analysis of Radiological Causes of Cutting-Out After Treatment of Intertrochanteric Femur Fracture
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Han Gwang-Sik
Jung Byung-Hyun
Ahn Jong-Kuk
Cho Jin-Ho
Chung Hyung-Jin
Kim Jin-Hwan
Sung Yerl-Bo
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Abstract
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Purpose: The aim of this study was to predict and prevent the cutting-out of the lag screw in the treatment of intertochantic fractures of the hip treated with a compression hip screw.
Materials and Methods: A clinical analysis was performed of 8 cases demonstrating a cutting-out of the lag screw among 293 cases of intertrochanteric fracture which had been treated by compression hip screw between August 1989 and May 19997. The fracture pattern. Singhindex, the position of the lag screw, and the results of surgery were analyzed by pre- and postoperative plain radiography. In order to analyzed the accuracy of fixatin, we used TAD(tip-apex distance).
Results: In the 8 cases of cutting-out that developed, 7 cases were female and they were all over 70 years of age. Unstable fracture was demonstrated in 7 cases according to Evans classification. The average period of cutting-out was 10 months, and the average TAD was 33.4 ㎜ and the position of the screw was not central (off center ?) in 5 cases.
Conclusion: In elderly patients with osteoporosis and unstable intertrochanteric fractures, TAD must be under 25 ㎜ and the lag screw should be cnetered in the femoral head. Otherwise, if stable fixation is imossible, we must consider
using primary hip arthroplasty.
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KEYWORD
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cutting-out, Femur, Intertrochanteric fracture, Compression hip screw, Cutting out
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