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KMID : 0386720060180010067
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Journal of the Korean Hip Society
2006 Volume.18 No. 1 p.67 ~ p.72
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Fixation for Reattachment of Trochanteric Fragment in Pertrochanteric Fracture Treated with Bipolar Hemiarthroplasty
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Kim Weon-Yoo
Han Chang-Hwan
Ji Jong-Hun
Kim Young-Yul
Lee Kyo-Sun
Lee Se-Won
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Abstract
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Purpose: To retrospectively compare the fixation methods for reattaching a trochanteric fragment in a pertrochanteric fracture treated with bipolar hemiarthroplasty.
Materials and methods: Forty cases of an unstable femur pertrochanteric fracture were analyzed and followed up for average of 19(6~40) months. There were 18 cases fixed with tension band wiring (group 1), 7 cases treated using modified tension band wiring with K-wires (group 2) and 15 cases treated with the GTRD (Greater Trochanteric Reattachment Device) (group 3).
Result: Group 1 was treated with simple a surgical procedure and the results were good. The second group had firm fixation postoperatively but required additional surgery in two cases to remove the K-wires because of wire migration after ambulation. Group 3 had relatively good results but required more dissection and a longer operating time.
Conclusion: Tension band wiring or GTRD are good fixation methods for reattaching trochanteric fragments in pertrochanteric fractures. Moreover, tension band wiring is recommended for old osteoporotic patients due to a simple procedure and firm fixation. The use of modified tension band wiring using K-wire or a Steinmann-pin should not be used due to the possibility of distant migration.
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KEYWORD
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Trochanteric fragment, Pertrochanteric facture, GTRD, Bipolar hemiarthroplasty
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