|
KMID : 0386720020140010040
|
|
Journal of the Korean Hip Society
2002 Volume.14 No. 1 p.40 ~ p.48
|
|
|
Treatment of Unstable Intertrochanteric Fracture of the Femur Using Sliding Hip Screw in the Elderly: Fixation of lesser trochanter and radiographic results
|
|
Chung Young-Yool
Ahn YC
Kim Hee-Dong
|
|
|
Abstract
|
|
|
Purpose : To evaluate the effect of fixation of lesser trochanter in the treatment of unstable intertrochanteric fracture using sliding hip screw.
Materials and Methods : This study comprised 31 elderly patients who had unstable inter trochanteric fracture. The average age of patients was 75.36 years. The fractures were classified using the Evans-Jensen classification system. The lesser trochanters were fixed in sixteen cases. The correlations between lag screw position, comminution of fracture site, method of fixation of lesser trochanter, and radiological results were studied. Nonunion was diagnosed if patients experienced pain and radiographs revealed a persistent, radiolucent defect at the fracture site 6 months after fracture fixation.
Results : Average union time was 3.85 months. Nonunion was observed in 4(13%) cases. The position of the lag screw and TAD were not correlated to the degree of penetration of the femoral head. Average sliding distance of the lag screw was 9.16 mm. Sliding distance of the lag screw was the least in the cases that the posteromedial fragment was fixed with figure of 8 wiring. Excessive sliding, defined as more than 15 mm, was developed in 7 cases, six of which were type 3 fractures. Complications were nonunion in 4 cases, severe limping in 2, and avulsion fracture of greater trochanter in 2.
Conclusion : There was no statistical correlation between lesser trochanter fixation and radiological results among type 2A and 2B fractures that had not undergone posteromedial severe comminution. But anatomical reduction and stable fixation of posteromedial fragment including lesser trochanter, in cases of severe comminuted unstable intertrochanteric fractures, can prevent excessive lag screw sliding and facilitate early mobilization.
|
|
|
KEYWORD
|
|
|
Femur, Intertrochanteric fracture, Sliding hip screw, Fixation of lesser trochanter
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
 
|
|