Ho-Seung Jeon; Byung-Mun Park; Kyung-Sub Song; Hyung-Gyu Kim; Jong-Ju Yun

doi:10.12671/jkfs.2009.22.3.131

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Jeon, Park, Song, Kim, and Yun: The Comparison between ITST™ (Intertrochanteric/Subtrochanteric) & DHS (Dynamic Hip Screw) in Unstable Femur Intertrochanteric Fracture

Original Article

Journal of the Korean Fracture Society 2009; 22(3): 131-137.

Published online: 31 July 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.3.131

The Comparison between ITST™ (Intertrochanteric/Subtrochanteric) & DHS (Dynamic Hip Screw) in Unstable Femur Intertrochanteric Fracture

Ho-Seung Jeon, M.D.^*, Byung-Mun Park, M.D., Kyung-Sub Song, M.D., Hyung-Gyu Kim, M.D., Jong-Ju Yun, M.D.

Department of Orthopedic Surgery, Kwangmyung Sung-Ae General Hospital, Gwangmyung, Korea.

^*Department of Orthopedic Surgery, Sung-Ae General Hospital, Seoul, Korea.

Address reprint requests to: Kyung-Sub Song, M.D. Department of Orthopedic Surgery, Gwangmyung Sung-Ae General Hospital, 389, Cheolsan 3-dong, Gwangmyung 423-711, Korea. Tel: 82-2-2680-7233, Fax: 82-2-2680-7755, sksub@paran.com

Received 8 November 2008 Revised 27 December 2008 Accepted 27 April 2009

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate between DHS and ITST nail (2^nd generation) on the treatment of unstable femur intertrochanteric fracture in patients over 70 years old.

Materials and Methods

61 cases of unstable intertrochanteric fracture (grouped 37 patients with DHS and 24 patients with ITST) who were taken the operation from Mar. 2003 to Sep. 2007 were analysed regarding to union time, sliding length of lag screws, operation time, blood loss, postoperative complications and functional recovery score by Skovron.

Results

The mean union time was 14.7 weeks in study group (ITST). The mean union time was 16.2 weeks in control group (DHS). The lag screw slidings were 7.2 mm in study group and 8.7 mm in control group. The operation times were 57.9 min in study group and 76.9 min in control group. The amount of blood loss were 67.7 ml in study group and 227.4 ml in control group. The complications were 4 cases in study group and 4 cases in control group. The Skovron recovery scores were 76.5% in study group and 73.7% in control group.

Conclusion

From a practical point of short operation time, less amount of bleeding and less complication, author think that the ITST nail is useful implant for treatment of unstable femur intertrochanteric fracture in patient of old age.

Keywords: Unstable intertrochanteric fracture, DHS (Dynamic Hip Screw), ITST (Intertrochanteric/Subtrochanteric) IM nail

Figures and Tables

Fig. 1

(A) Initial radiograph in 84-year-old woman shows unstable intertrochanteric fracture according to EVANS classification.

(B, C) Immediate postoperative radiograph of internal fixation with DHS and TSP.

(D, E) Postoperative 14 months radiograph shows complete union of fracture site, 3 mm slippage of lag screw and 3 degree change of neck-shaft angle without lateral displacement of greater trochanter.

Fig. 2

(A, B) Initial radiograph in 76-year-old man shows unstable intertrochanteric fracture according to EVANS classification.

(C, D) Immediate postoperative radiograph shows that fixation was done with ITST, lag screw was placed in center.

(E, F) Postoperative 8 months radiograph shows complete union of fracture site, 2 mm slippage of lag screw.

Table 1

Comparison between DHS and ITST in unstable intertrochanteric fracture

^*W.B.: Weight bearing, ^†p<0.05.

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