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Abstract
Purpose
To evaluate the radiologic results between compressive hip screw and compressive hip screw with additional trochanteric stabilizing plate in patients with femoral unstable intertrochanteric fractures in patients with more 65 years old.
Materials and Methods
From 2006 to May 2009, 121 cases were included. Group I (compressive hip screw only) was 54 cases and group II (compressive hip screw with trochanteric stabilizing plate) was 67 cases. We checked the lag screw sliding, lateral translation of greater trochanter, changes of neck-shaft angle and complications through periodic follow up of radiographs.
Results
Mean lag screw sliding was 7.6 mm in group I and 3.9 mm in group II (p=0.001). Mean lateral translation of greater trochanter was 3.86 mm in group I and 0.59 mm in group II (p=0.01). Mean changes of neck-shaft angle was nearly the same, 3.57° in group I and 3.66° in group II. Complications were 15 cases in group I and 10 cases in group II.
Conclusion
Compressive hip screw with additional trochanteric stabilizing plate was effective surgical option in patients with femoral unstable intertrochanteric fractures in patients with more than 65 years old. It decreased lag screw sliding, lateral translation of greater trochanter and complication rates.
Figures and Tables
Fig. 1
Schematic diagram showing Doppelt's method. To measure the extent of sliding and greater trochanter latelaization, correction factor was applied. Correction factor=B/b, the extent of sliding=A-a×B/b, the extent of lateral displacement=c-C×B/b.
Fig. 2
(A) Initial radiograph shows the right femoral unstable intertrochanteric fracture of AO type A2.2.
(B) Postoperative radiograph shows the anatomical reduction with good alignment. Fracture site are reduced and stabilized with compressive hip screw.
(C) Final follow up radiograph shows the varus collapse and eventually non-united of fracture site.
Fig. 3
(A) Initial radiograph shows the left femoral unstable intertrochanteric fracture of AO type A2.3.
(B) Postoperative radiograph shows the anatomical reduction with good alignment. Fracture site are reduced and stabilized with compressive hip screw and additional trochanteric stabilizing plate.
(C) Final follow up radiograph shows the impaction of fracture site and complete union.
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