Analysis of the Causes for Failed Compression Hip Screws in Femoral Intertrochanteric Fracture and Hip Reconstruction Operation

Ui Seoung Yoon; Jin Soo Kim; Jae Sung Seo; Jong Pil Yoon; Seung Yub Baek

doi:10.12671/jkfs.2010.23.3.270

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Yoon, Kim, Seo, Yoon, and Baek: Analysis of the Causes for Failed Compression Hip Screws in Femoral Intertrochanteric Fracture and Hip Reconstruction Operation

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2010; 23(3): 270-275.

Published online: 31 July 2010

DOI: https://doi.org/10.12671/jkfs.2010.23.3.270

Analysis of the Causes for Failed Compression Hip Screws in Femoral Intertrochanteric Fracture and Hip Reconstruction Operation

Ui Seoung Yoon, M.D., Jin Soo Kim, M.D., Jae Sung Seo, M.D., Jong Pil Yoon, M.D., Seung Yub Baek, M.D.

Department of Orthopedic Surgery, Seoul Medical Center, Seoul, Korea.

Address reprint requests to: Jin Soo Kim, M.D. Department of Orthopedic Surgery, Seoul Medical Center, 171-1, Samsung-dong, Gangnam-gu, Seoul 135-740, Korea. Tel: 82-2-3430-3501, Fax: 82-2-539-1262, rocketkjs@gmail.com

Received 26 February 2010 Revised 15 March 2010 Accepted 17 May 2010

(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 analyze the causes of fixation failure of compression hip screw and evaluate outcomes of hip arthroplasty for reconstruction.

Materials and Methods

We reviewed 108 femoral intertrochanteric fractures that underwent compression hip screw between January 1997 and December 2007. Failure group (group I) contained 28 cases who had hip arthroplasty for failed compression hip screw and the control group (group II) contained 80 cases who had successive compression hip screw. We analyzed the causes of failure of compression hip screw and evaluated the results of hip arthroplasty for reconstruction.

Results

In group I, 21 cases (75%) were unstable fractures. Group II, 14 cases (17%) were unstable fractures. Tip-apex distance was 26.5 (18~35) mm in group I and 18.6 (8~22) mm in group II. Lateral wall fracture of greater trochanteric area was combined in 24 cases (85.7%) in group I and 9 cases (11.3%) in group II. Harris Hip Score improved from 33.5 (22~43) points to 84.2 (75~93) points after salvage hip arthroplasty.

Conclusion

We considered the causes of failed compression hip screw to be fracture instability, increased tip-apex distance and presence of lateral wall fracture of greater trochanter. Hip arthroplasty was found to be a useful method for failed compression hip screw.

Keywords: Femur, Intertrochanteric fracture, Compression hip screw

Figures and Tables

Fig. 1

A 87-year-old female with left hip pain, (A) Preoperative radiograph showing a unstable intertrochanteric fracture with lateral wall fracture.

(B) The fracture was fixed by using compression hip screw.

(C) Postoperative 3 months follow-up. The lag screw slid excessively and nearly protruded a femoral head. The acetabular surface was preserved.

(D) Postoperative 18months follow-up. Radiograph showing well fixed components after bipolar hemiarthroplasty.

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