Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture

Kwang-Jun Oh; Sung-Tae Lee; Suk-Ha Lee; Jin-Ho Hwang; Min-Suk Kang

doi:10.12671/jkfs.2010.23.1.6

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Oh, Lee, Lee, Hwang, and Kang: Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2010; 23(1): 6-12.

Published online: 31 January 2010

DOI: https://doi.org/10.12671/jkfs.2010.23.1.6

Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture

Kwang-Jun Oh, M.D., Sung-Tae Lee, M.D., Suk-Ha Lee, M.D., Jin-Ho Hwang, M.D., Min-Suk Kang, M.D.

Department of Orthopedic Surgery, Konkuk University Medical School, Seoul, Korea.

Address reprint requests to: Jin-Ho Hwang, M.D. Department of Orthopedic Surgery, Konkuk University Medical School, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-914, Korea. Tel: 82-2-2030-7495, Fax: 82-2-2030-7369, osjinho@naver.com

Received 28 July 2009 Revised 3 September 2009 Accepted 15 December 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 the radiographic and functional outcomes between who had unstable intertrochanteric fracture, treated with the ITST (lag screw design) and the PFNA (helical blade design).

Materials and Methods

We selected each 17 and 13 patients of unstable intertrochanteric fracture which were treated with ITST or PFNA from April 2005 to December 2008. We evaluated the radiographic results by follow-up radiography and the clinical outcomes with the mobility score of Parker and Palmer, Social function scoring system.

Results

The mean sliding distance of cervical screw with ITST nails was not shown significant differences than with using PFNA nails. The other factors were not statistically different. Decrease of mobility score of Parker and Palmer, Social function score were similar. 2 cases of cutting out was noted with ITST nails and 1 case of cutting out was noted with PFNA nails.

Conclusion

Unlike the existed biomechanical reposts, there are no differences that are clinical and radiological results in treatment of unstable intertrochanteric fracture using the ITST nails and PFNA nails.

Keywords: Femur intertrochanteric fracture, Proximal femoral nail A, Intertrochanteric/subtrochanteric fixation

Figures and Tables

Fig. 1

The ITST (Zimmer) with lag screw. 2 cm of threaded lag screw length, 130° of neck-shaft angle, 5° of medial-lateral angle.

Fig. 2

The PFNA/II (Synthes) with a helical blade. 3 cm of helical blade length, 125° or 130° of neck-shaft angle, 6° of medial-lateral angle (PFNA)/5° of medial-lateral angle (PFNAII).

Fig. 3

(A) 66 years old male had unstable hip fracture by slip down. (B) Treated with ITST. (C) Cutting out by varus deformity. (D) Total hip replacement arthroplasty was done.

Fig. 4

(A) 76 years old female had unstable hip fracture by slip down. (B) Treated with ITST. (C) Cutting out. (D) Bipolar hemiarthroplasty was done.

Fig. 5

(A) 58 years old male had unstable hip fracture by slip down. (B) Treated with PFNA-II. (C) Cutting out by medial migration of helical blade. (D) Treated with angled blate plate.

Table 1

AO/OTA classification

Table 2

Classification of reduction

Table 3

Immediately postoperative reduction status

Table 4

Comparison of radiologic results between lag screw group and helical blade group

Table 5

Comparison of clinical outcomes between lag screw group and helical blade group

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